Model # Model # Cushion Extra Outer Cover Width Depth Cushion Extra Outer Cover

Size: px
Start display at page:

Download "Model # Model # Cushion Extra Outer Cover Width Depth Cushion Extra Outer Cover"

Transcription

1 MATRX SEATING SERIES Matrx Vi Cushion Matrx Vi Cushions include inner & outer covers. Additional Extra covers are also available. Weight Capacity up to 300 lbs. Fits Wheelchair Cushion Extra Outer Cover Width Depth Cushion Extra Outer Cover MA1415 Vi C ",14" 15",16" $425 MA1417 Vi C ",14" 17",18" $425 MA1616 Vi C ",16" 16",17" $425 MA1618 Vi C ",16" 18",19" $425 MA1620 Vi C ",16" 20",21" $425 MA1816 Vi C ",18" 16",17" $425 MA1818 Vi C ",18" 18",19" $425 MA1820 Vi C ",18" 20",21" $425 MA2016 Vi C ",20" 16",17" $425 MA2018 Vi C ",20" 18",19" $425 MA2020 Vi C ",20" 20",21" $425 MA2218 Vi C ",22" 18",19" $475 $110 MA2220 Vi C ",22" 20",21" $475 $110 Matrx Vi Heavy Duty Cushion* MaTtrx Vi Cushions include inner & outer covers. Additional Extra covers are also available. Weight Capacity up to 600 lbs. Specify Cushion Extra Outer Cover Width Depth Cushion Extra Outer CoVier MAWWDD Vi CWWDD See chart See chart $625 $150 * You must specify the width and depth that you require for these cushions. These cushions will take an additional additional 1 week lead time 84 Citation Drive, Unit 1 7, Concord, ON L4K 3C1 1 of 18 Tel: Fax:

2 MATRX SEATING SERIES Kidabra Cushion Kidabra cushions include inner & outer covers. Additional Extra covers are also available. Weight Capacity up to 150 lbs Fits Wheelchair Cushion Extra Outer Cover Width Depth Cushion Extra Outer Cover KA1212 Vi KC ",12" 12",13" $425 $95 KA1214 Vi KC ",12" 14",15" $425 $95 KA1412 Vi KC ",14" 12",13" $425 $95 KA1414 Vi KC ",14" 14",15" $425 $95 Modifications Add modification upcharge to price of Matrx Cushion. Modification POK Pelvic Obliquity Kit Accommodates 1/2" and 1" obliquities $50 SDR1 Seat Depth Reduction* Cushion Depth Less 1" SDR2 Seat Depth Reduction* Cushion Depth Less 2" SDR3 Seat Depth Reduction* Cushion Depth Less 3" SDR4 Seat Depth Reduction* Cushion Depth Less 4" LLDR1 Leg Length Discrepancy* Cushion Depth User's Right Less 1" LLDR2 Leg Length Discrepancy* Cushion Depth User's Right Less 2" LLDL1 Leg Length Discrepancy* Cushion Depth User's Left Less 1" LLDL2 Leg Length Discrepancy* Cushion Depth User's Left Less 2" ECM Extra Outer Cover Modification* Accommodates LLD/SDR $50 MAC Miscellaneous Modification Special Request requires approval CIC Extra Inner Cover Available for Matrx Cushions and Bases NSF Non Standard Fabric Selection** Optional Kidabra or Black Fabric N/C OCU MA Onyx Cover Upgrade*** Available for Matrx Cushions VC MA Vinyl Cover Upgrade*** Available for Matrx Cushions/Extra Covers $50 DAR F Dartex Fabric side up*** Available for Matrx Cushions/Bases $50 DAR S Dartex Smooth side up*** Available for Matrx Cushions/Bases $50 *Available on Matrx V/Kidabra cushions only not bases ** Applies only at time of ordering Matrx PB Back or Matrx Cushion or extra cover. ***You may select fabric of seating products at time of ordering adds additional 1 week lead time. 84 Citation Drive, Unit 1 7, Concord, ON L4K 3C1 2 of 18 Tel: Fax:

3 Matrx PS Cushion MATRX SEATING SERIES Matrx PS Cushions include an inner liner and reversible outer cover. Additional outer covers are also available Weight Capacity up to 300 lbs. Fits Wheelchair Cushion Extra Outer Cover Width Depth Cushion Extra Outer Cover PS1010 PSC1010 9",10" 10",11" $345 $85 PS1012 PSC1012 9",10" 12",13" $345 $85 PS1014 PSC1014 9",10" 14",15" $345 $85 PS1212 PSC ",12" 12",13" $345 $85 PS1214 PSC ",12" 12",13" $345 $85 PS1216 PSC ",12" 12",13" $345 $85 PS1412 PSC ",14" 14",15" $345 $85 PS1414 PSC ",14" 14",15" $345 $85 PS1416 PSC ",14" 14",15" $345 $85 PS1616 PSC ",16" 16",17" $345 $85 PS1618 PSC ",16" 18",19" $345 $85 PS1620 PSC ",16" 20",21" $345 $85 PS1816 PSC ",18" 16",17" $345 $85 PS1818 PSC ",18" 18",19" $345 $85 PS1820 PSC ",18" 20",21" $345 $85 PS2016 PSC ",20" 16",17" $345 $85 PS2018 PSC ",20" 18",19" $345 $85 PS2020 PSC ",20" 20",21" $345 $85 Matrx PS Heavy Duty Cushion* Bariatric Builder Sizes Weight Capacity 500 lbs. Bariatric PS Dartex covers are NOT reversible. Please specify smooth or fabric side out at time of order. Specify Cushion Extra Outer Cover Width Depth Cushion Extra Outer Cover PSWWDD PSCWWDD See chart See chart $695 $125 * You must specify the width and depth that you require for these cushions. These cushions will take an additional week 84 Citation Drive, Unit 1 7, Concord, ON L4K 3C1 3 of 18 Tel: Fax:

4 Modifications MATRX SEATING SERIES Add modification upcharge to price of Matrx PS Cushion. Modification PSPOK R or PSPOK L Pelvic Obliquity Kit with Cushion Accommodates 1/2" and 1" Modification (Specify user's right or left) obliquities SDR1 Seat Depth Reduction* Cushion Depth Less 1" SDR2 Seat Depth Reduction* Cushion Depth Less 2" SDR3 Seat Depth Reduction* Cushion Depth Less 3" SDR4 Seat Depth Reduction* Cushion Depth Less 4" LLDR1 Leg Length Discrepancy* Cushion Depth User's Right Less 1" LLDR2 Leg Length Discrepancy* Cushion Depth User's Right Less 2" LLDL1 Leg Length Discrepancy* Cushion Depth User's Left Less 1" LLDL2 Leg Length Discrepancy* Cushion Depth User's Left Less 2" ECM Extra Outer Cover Modification* Accommodates LLD/SDR $50 MAC Miscellaneous Modification Special Request requires approval PSIL WWDD Extra Inner Liner Available for Matrx PS Cushions. $35 *You may select fabric of seating products at time of ordering adds additional 1 week lead time. Cushion cover will no be reversible and you must specify smooth or fabric side out. Matrx V Cushion Rigidizer Rigidizer Lightweight, moulded solid seat insert, recommended for use with cushions being used on sling seat upholstery. Fits Cushion Width Depth CR14S 12" 14" 12" 17" CR16S 15",16" 15",16" CR16M 15",16" 17",18" CR16L 15",16" 19",20" CR18S 17",18" 15",16" CR18M 17",18" 17",18" CR18L 17",18" 19",20" CR20S 19",20" 15",16" CR20M 19",20" 17",18" CR20L 19",20" 19",20" CR22M 21",22" 17",18" $95 CR22L 21",22" 19",20" $95 84 Citation Drive, Unit 1 7, Concord, ON L4K 3C1 4 of 18 Tel: Fax:

5 MATRX SEATING SERIES Matrx Vi Base Matrx Vi Bases include a plywood drop base and mounting hardware. Please specify drop hook size 7/8 or 1" dia., 1" or 2" drop. Weight Capactiy up to 250 lbs. Fits Wheelchair Base Extra Outer Cover Width Depth Base Extra Outer Cover MB1415 Vi BC " 15",16" $625 $90 MB1417 Vi BC " 17",18" $625 $90 MB1516 Vi BC " 16",17" $625 $90 MB1518 Vi BC " 18",19" $625 $90 MB1616 Vi BC " 16",17" $625 $90 MB1618 Vi BC " 18",19" $625 $90 MB1716 Vi BC " 16",17" $625 $90 MB1718 Vi BC " 18",19" $625 $90 MB1816 Vi BC " 16",17" $625 $90 MB1818 Vi BC " 18",19" $625 $90 MB1916 Vi BC " 16",17" $625 $90 MB1918 Vi BC " 18",19" $625 $90 MB2016 Vi BC " 16",17" $625 $90 MB2018 Vi BC " 18",19" $625 $90 Kidabra Base Kidabra Bases include a plywood drop base and mounting hardware. Please specify drop hook size 7/8 or 1" dia., 1" or 2" drop. Weight Capactiy up to 150 lbs. Fits Wheelchair Base Extra Outer Cover Width Depth Base Extra Outer Cover KB1212 Vi KBC " 12",13" $625 $90 KB1214 Vi KBC " 14",15" $625 $90 KB1312 Vi KBC " 12",13" $625 $90 KB1314 Vi KBC " 14",15" $625 $90 KB1412 Vi KBC " 12",13" $625 $90 KB1414 Vi KBC " 14",15" $625 $90 Please select Drop Hooks For extra drop hooks please see hardware page. Front Set 7/8" 1" Flush (0") Rear Set 7/8" 1" Flush (0") Calf Straps and Lap Belts Accessory BP CS M Air mesh Calf Strap Medium 3.5" pad height, fits chairs 15" 18" wide $95 BP CS L Airmesh Calf Strap Large 3.5" pad height, fits chairs 18" 22" wide $95 BP CP MD Air mesh Calf Panel Medium 35.5"W x 9"H pad height, fits chairs 15" 18" wide $125 BP CP LG Air mesh Calf Panel Large 38.5"W x 9"H" pad height, fits chairs 18" 22" wide $140 BP PLB2 Padded Lap Belt 2 point Center pull, push button, padded lap belt fits hip width 13" 19" $135 BP PLB4 Padded Lap Belt 4 point Center pull, push button, padded lap belt fits hip width 13" 19" $ Citation Drive, Unit 1 7, Concord, ON L4K 3C1 5 of 18 Tel: Fax:

6 MATRX SEATING SERIES Matrx PB Posture Back Back includes outer cover. Hardware not included must be ordered separately. 16" and 20" back heights are complete with reinforcement plate for head support. Contour depth is 5". Weight Capacity up to 300 lbs Fits Wheelchair Back Extra Outer Cover Width Height Back Extra Outer Cover MPB1412 NH PBC " 15" 12" $400 MPB1416 NH PBC " 15" 16" $400 MPB1612 NH PBC " 17" 12" $400 MPB1616 NH PBC " 17" 16" $400 MPB1620 NH PBC " 17" 20" $400 MPB1712 NH PBC " 18" 12" $400 MPB1716 NH PBC " 18" 16" $400 MPB1720 NH PBC " 18" 20" $400 MPB1812 NH PBC " 19" 12" $400 MPB1816 NH PBC " 19" 16" $400 MPB1820 NH PBC " 19" 20" $400 MPB2012 NH PBC " 21" 12" $400 MPB2016 NH PBC " 21" 16" $400 MPB2020 NH PBC " 21" 20" $ Citation Drive, Unit 1 7, Concord, ON L4K 3C1 6 of 18 Tel: Fax:

7 MATRX SEATING SERIES Select Hardware: Hardware PBMH Posture Back Mounting Hardware (per Complete Mounting assembly for pair) Posture Back PBMH Q Posture Back Mounting Hardware (per Complete Mounting assembly for pair) Posture Back with 1 1/8" back canes PBMH L Large Posture Back Mounting Hardware Complete Mounting assembly for (per pair) Posutre Back with 1 1/4" back canes SMH* Split Mounting Hardware (Per pair) Split Mounting hardware assembly for Posture Back FSSH Fixed Space Saver Hardware Allows fixed, non removable mounting of Posture Back HDMH Heavy Duty PB Mounting Hardware(per Heavy Duty Mounting Hardware pair) Assembly for Posture Back $325 *Split Hardware available on standard sizes up to 20" wide and maximum 300 lbs capacity PB Back Accessories Accessory MAC Miscellaneous Modification Special Request requires approval Posture Back or Elite Back Foam PBVF ViscoFoam option Modification FIP Foam in Place Kit for Matrx Posture Back Chemical kit for custom foam mould $200 PBSC Posture Back Stretch Cover Upgrade** For use with Foam in place kits on Matrx PB Backs $50 PBCR Posture Back Cane Replacement (per pair) 1" diameter back cane replacement kit $115 EMP Extended Mounting Pins Allows Matrx Elite back or Posture Back to be installed on wheelchairs $40 that are 2" wider than the back model CHIPB Chest Harness Interface Kit for PB Back Chest Harness is not included mounting kit only $45 84 Citation Drive, Unit 1 7, Concord, ON L4K 3C1 7 of 18 Tel: Fax:

8 MATRX SEATING SERIES Matrx PB Heavy Duty Posture Back Back includes outer cover and hardware to fit 3/4", 7/8" or 1" diameter back canes and is drilled for head support attachement. Contour depth 5". Weight Capacity 500 lbs. Fits Wheelchair Back Extra Outer Cover Width Height Back Extra Outer Cover HDB2016 HDC ",21" 16" $835 HDB2020 HDC ",21" 20" $835 HDB2216 HDC ",23" 16" $835 HDB2220 HDC ",23" 20" $835 HDB2416 HDC ",25" 16" $835 HDB2420 HDC ",25" 20" $835 Extra Wide Heavy Duty Posture Back for seat widths up to 30" wide* HDBww16 HDCww16 up to 30" 16" add $600 add HDBww20 HDCww20 up to 30" 20" add $600 add Matrx PB Deep Posture Back Back includes outer cover. Hardware not included must be ordered separately Back is drilled for head support attachment. Contour depth 7" Weight capacity is 300 lbs. Fits Wheelchair Back Extra Outer Cover Width Height Back Extra Outer Cover PBD1412 NH DMC " 15" 12" $470 $110 PBD1416 NH DMC " 15" 16" $470 $110 PBD1612 NH DMC " 17" 12" $470 $110 PBD1616 NH DMC " 17" 16" $470 $110 PBD1620 NH DMC " 17" 20" $470 $110 PBD1712 NH DMC " 18" 12" $470 $110 PBD1716 NH DMC " 18" 16" $470 $110 PBD1720 NH DMC " 18" 20" $470 $110 PBD1812 NH DMC " 19" 19 12" $470 $110 PBD1816 NH DMC " 19" 16" $470 $110 PBD1820 NH DMC " 19" 20" $470 $110 PBD2012 NH DMC " 21" 12" $470 $110 PBD2016 NH DMC " 21" 16" $470 $110 PBD2020 NH DMC " 21" 20" $470 $110 Matrx PB Deep HD Posture Back Back includes outer cover and hardware to fit 3/4", 7/8" or 1" diameter back canes and is drilled for head support attachment. Contour depth 7" Weight Capacity up to 500 lbs Fits Wheelchair Back Extra Outer Cover Width Height Back Extra Outer Cover DHD2016 DDC ",21" 16" $935 $110 DHD2020 DDC ",21" 20" $935 $110 DHD2216 DDC ",23" 16" $935 $110 DHD2220 DDC ",23" 20" $935 $110 DHD2416 DDC ",25" 16" $935 $110 DHD2420 DDC ",25" 20" $935 $110 Extra Wide Heavy Duty Deep Posture Back for seat widths up to 30" wide* DHDww16 DDCww16 up to 30" 16" add $600 add DHDww20 DDCww20 up to 30" 20" add $600 add 84 Citation Drive, Unit 1 7, Concord, ON L4K 3C1 8 of 18 Tel: Fax:

9 Select Hardware: MATRX SEATING SERIES Hardware PBMH Posture Back Mounting Hardware (per Complete Mounting assembly for pair) Posture Back PBMH Q Posture Back Mounting Hardware (per Complete Mounting assembly for pair) Posture Back 1 1/8" back canes PBMH L Large Posture Back Mounting Hardware Complete Mounting assembly for (per pair) Posutre Back with 1 1/4" back canes SMH* Split Mounting Hardware (Per pair) Split Mounting hardware assembly for Posture Back FSSH Fixed Space Saver Hardware Allows fixed, non removable mounting of Posture Back HDMH Heavy Duty PB Mounting Hardware(per Heavy Duty Mounting Hardware pair) Assembly for Posture Back $325 *Split Hardware available on standard sizes up to 20" wide and maximum 300 lbs capacity PB Back Accessories Accessory MAC Miscellaneous Modification Special Request requires approval PBVF Posture Back or Elite Back Foam Modification ViscoFoam option FIP Foam in Place Kit for Matrx Posture Back Chemical kit for custom foam mould $200 PBSC Posture Back kstretch t Cover Upgrade** For use with Foam in place kits on Matrx PB Backs $50 PBCR Posture Back Cane Replacement (per pair) 1" diameter back cane replacement kit $115 Allows Matrx Elite back or Posture EMP Extended Mounting Pins Back to be installed on wheelchairs $40 that are 2" wider than the back model CHIPB Chest Harness Interface Kit for PB Back Chest Harness is not included mounting kit only $45 PFLAP XS Privacy Flap for Matrx Backs Fits Matrx backs 12 14" wide (Flap size 10" x 16") $40 PFLAP S Privacy Flap for Matrx Backs Fits Matrx backs 15 16" wide (Flap size 13" x 16") $40 PFLAP M Privacy Flap for Matrx Backs Fits Matrx backs 17 18" wide (Flap size 15" x 16") $40 PFLAP L Privacy Flap for Matrx Backs Fits Matrx backs 19 20" wide (Flap size 17" x 16") $40 PFLAP XL Privacy Flap for Matrx Backs Fits Matrx backs 21 22" wide (Flap size 19" x 16") $40 PFLAP XXL Privacy Flap for Matrx Backs Fits Matrx backs 23 24" wide (Flap size 21" x 16") $40 84 Citation Drive, Unit 1 7, Concord, ON L4K 3C1 9 of 18 Tel: Fax:

10 MATRX SEATING SERIES Matrx Elite Back Back includes foam and cover and hardware to fit 3/4, 7/8" or 1" diameter back canes. Backs are drilled for headrest attachment (exceptions are 15" 20" wide x 10"/12" high). Contour Depth 3", Weight Capacity up to 300 lbs. Fits Wheelchair Back Extra Outer Cover* Width Height Back Extra Outer Cover* ~ Optional "Full Back" non scapular cut out *includes foam PBE1210 NH PBEC " 13" 10" $400 $135 PBE1212 NH PBEC " 13" 12" $400 $135 PBE1214 NH PBEC " 13" 14" $400 $135 PBE1216 NH PBEC " 13" 16" $400 $135 PBE1218 NH PBEC " 13" 18' $400 $135 PBE1310 NH PBEC " 14" 10" $400 $135 PBE1312 NH PBEC " 14" 12" $400 $135 PBE1314 NH PBEC " 14" 14" $400 $135 PBE1316 NH PBEC " 14" 16" $400 $135 PBE1318 NH PBEC " 14" 18" $400 $135 PBE1410 NH PBEC " 15" 10" $400 $135 PBE1412 NH PBEC " 15" 12" $400 $135 PBE1414 NH PBEC " 15" 14" $400 $135 PBE1416 NH PBEC " 15" 16" $400 $135 PBE1418 NH PBEC " 15" 18" $400 $135 PBE1420 NH PBEC " 15" 20" $400 $135 PBE1510 NH PBEC " 16" 10" $400 $135 PBE1512 NH PBEC " 16" 12" $400 $135 PBE1514 NH PBEC " 16" 14" $400 $135 PBE1516 NH PBEC " 16" 16" $400 $135 PBE1518 NH PBEC " 16" 18" $400 $135 PBE1520 NH PBEC " 16" 20" $400 $135 PBE1610 NH PBEC " 17" 10" $400 $135 PBE1612 NH PBEC " 17" 12" $400 $135 PBE1614 NH PBEC " 17" 14" $400 $135 PBE1616 NH PBEC " 17" 16" $400 $135 PBE1618 NH PBEC " 17" 18" $400 $135 PBE1620 NH~ PBEC " 17" 17" 20" $400 $135 PBE1710 NH PBEC " 18" 10" $400 $135 PBE1712 NH PBEC " 18" 12" $400 $135 PBE1714 NH PBEC " 18" 14" $400 $135 PBE1716 NH PBEC " 18" 16" $400 $135 PBE1718 NH PBEC " 18" 18" $400 $135 PBE1720 NH~ PBEC " 18" 20" $400 $135 PBE1810 NH PBEC " 19" 10" $400 $135 PBE1812 NH PBEC " 19" 12" $400 $135 PBE1814 NH PBEC " 19" 14" $400 $135 PBE1816 NH PBEC " 19" 16" $400 $135 PBEC1818 NH PBEC " 19" 18" $400 $135 PBE1820 NH~ PBEC " 19" 20" $400 $135 PBE1910 NH PBEC " 20" 10" $400 $135 PBE1912 NH PBEC " 20" 12" $400 $135 PBE1916 NH PBEC " 20" 16" $400 $135 PBEC1918 NH PBEC " 20" 18" $400 $135 PBE1920 NH~ PBEC " 20" 20" $400 $135 PBE2010 NH PBEC " 21" 10" $400 $135 PBE2012 NH PBEC " 21" 12" $400 $135 PBE2016 NH PBEC " 21" 16" $400 $135 PBE2018 NH PBEC " 21" 18" $400 $135 PBE2020 NH~ PBEC " 21" 20" $400 $ Citation Drive, Unit 1 7, Concord, ON L4K 3C1 10 of 18 Tel: Fax:

11 Matrx Elite Heavy Duty Back MATRX SEATING SERIES Back includes foam and cover and hardware to fit 3/4, 7/8" or 1" diameter back canes. Backs are drilled for headrest attachment. Contour Depth 3", Weight Capacity up to 500 lbs. Fits Wheelchair Back Extra Outer Cover* Width Height Back Extra Outer Cover* PBE2116 HD PBE2120 HD PBE2216 HD PBE2220 HD PBE2316 HD PBE2320 HD PBE2416 HD PBE2420 HD PBEC2116 PBEC2120 PBEC2216 PBEC2220 PBEC2316 PBEC2320 PBEC2416 PBEC " 22" 16" $795 $135 21" 22" 20" $795 $135 22" 23" 16" $795 $135 22" 23" 20" $795 $135 23" 24" 16" $795 $135 23" 24" 20" $795 $135 24" 25" 16" $795 $135 24" 25" 20" $795 $135 Extra Wide Heavy Duty Elite Back for seat widths up to 30" wide* PBEww16 HD PBEww20 HD PBECww16 up to 30" 16" add $600 add PBECww20 up to 30" 20" add $600 add Matrx Elite Tilt/Recline Back Back includes Supersoft foam and cover with no scapular cutout. Backs are drilled for headrest attachment. Contour depth 3". Suggested for tilt/recline applications. Weight Capacity up to 300 lbs. Hardware not included must be ordered seperately. Fits Wheelchair Back Extra Outer Cover* Width Height Back Extra Outer Cover* PBE1620 TR PBE1720 TR PBE1820 TR PBE1920 TR PBE2020 TR PBEC1620 PBEC1720 PBEC1820 PBEC1920 PBEC " 17" 20" $425 $135 17" 18" 20" $425 $135 18" 19" 20" $425 $135 19" 20" 20" $425 $135 20" 21" 20" $425 $ Citation Drive, Unit 1 7, Concord, ON L4K 3C1 11 of 18 Tel: Fax:

12 Matrx Elite Deep Back MATRX SEATING SERIES Back includes foam and cover and hardware to fit 3/4, 7/8" or 1" diameter back canes. 16", 18" and 20" back heights are pre drilled for headrest attachment. Contour Depth 6", Weight Capacity up to 300 lbs. Fits Wheelchair Back Extra Outer Cover* Width Height Back Extra Outer Cover* EDB1412 NH EDBC " 15" 12" $535 $135 EDB1416 NH EDBC " 15" 16" $535 $135 EDB1418 NH EDBC " 15" 18" $535 $135 EDB1420 NH EDBC " 15" 20" $535 $135 EDB1512 NH EDBC " 16" 12" $535 $135 EDB1516 NH EDBC " 16" 16" $535 $135 EDB1518 NH EDBC " 16" 18" $535 $135 EDB1520 NH EDBC " 16" 20" $535 $135 EDB1612 NH EDBC " 17" 12" $535 $135 EDB1616 NH EDBC " 17" 16" $535 $135 EDB1618 NH EDBC " 17" 18" $535 $135 EDB1620 NH EDBC " 17" 20" $535 $135 EDB1712 NH EDBC " 18" 12" $535 $135 EDB1716 NH EDBC " 18" 16" $535 $135 EDB1718 NH EDBC " 18" 18" $535 $135 EDB1720 NH EDBC " 18" 20" $535 $135 EDB1812 NH EDBC " 19" 12" $535 $135 EDB1816 NH EDBC " 19" 16" $535 $135 EDB1818 NH EDBC " 19" 18" $535 $135 EDB1820 NH EDBC " 19" 20" $535 $135 EDB1912 NH EDBC " 20" 12" $535 $135 EDB1916 NH EDBC " 20" 16" $535 $135 EDB1918 NH EDBC " 20" 18" $535 $135 EDB1920 NH EDBC " 20" 20" $535 $135 EDB2012 NH EDBC " 21" 21" 12" $535 $135 EDB2016 NH EDBC " 21" 16" $535 $135 EDB2018 NH EDBC " 21" 18" $535 $135 EDB2020 NH EDBC " 21" 20" $535 $135 Select Hardware: Hardware PBMH Posture Back Mounting Hardware (per pair) Complete Mounting assembly for Posture Back PBMH Q Posture Back Mounting Hardware (per pair) Complete Mounting assembly for Posutre Back with 1 1/8" back canes PBMH L Large Posture Back Mounting Hardware (per pair) Complete Mounting assembly for Posutre Back with 1 1/4" back canes SMH* Split Mounting Hardware (Per pair) Split Mounting hardware assembly for Posture Back FSSH Fixed Space Saver Hardware Allows fixed, non removable mounting of Posture Back HDMH Heavy Duty PB Mounting Hardware(per pair) Heavy Duty Mounting Hardware Assembly for $325 *Split Hardware available on standard sizes up to 20" wide and maximum 300 lbs capacity See next page for lateral options on the Elite Back 84 Citation Drive, Unit 1 7, Concord, ON L4K 3C1 12 of 18 Tel: Fax:

13 MATRX SEATING SERIES PB Back Accessories Accessory EBSS Elite Back Foam Modification SuperSoft Foam 1" soft over 1" firm HR foam with Meshtex cover MAC Miscellaneous Modification Special Request requires approval PBVF Posture Back or Elite Back Foam Modification ViscoFoam option PBCR Posture Back Cane Replacement (per pair) 1" diameter back cane replacement kit $115 Allows Matrx Elite back or Posture Back to be EMP Extended Mounting Pins installed on wheelchairs that are 2" wider than $40 the back model width. PRVFP Privacy Flap for Matrx Backs Includes velcro attachment on back $40 CHIEB Chest Harness Interface Kit for Elite Back Chest Harness is not included mounting kit only $95 Elite Laterals FIXED Available only on Matrx PB Elite Backs. Accessory PBLS L or PBLS R Standard Left Lateral with Fixed Hardware (each) Pad 7.5" long x 5" high PBSS L or PBSS R Small Left Lateral with Fixed Hardware (each) Pad 5.5" long x 3" high PBOL L or PBOL R Offset Lateral Pad with Fixed Hardware(each) for Allows 3" higher or lower pad position relative user's left/right when mounted up or the user's to attachment slot right/left when mounted down $110 SALEB XS L or SALEB XS R SALEB S L or SALEB S R SALEB M L or SALEB M R SALEB L L or SALEB L R Swing Away Elite Laterals Available only on Matrx PB Elite Backs Accessory Swing Away Lateral assembly (each) Extra Small Measured (height x length) Extra Small Lateral Pad 3.25" x 4.25"(each) Swing Away Lateral assembly (each) Small Small Lateral Pad 3.5" x 5.25"(each) Swing Away Lateral assembly (each) Medium Swing Away Lateral assembly (each) Large Medium Lateral Pad 3.75" x 5.75"(each) Large Lateral Pad 4.25" x 6.5"(each) $200 $200 $200 $200 Offset Swing Away Elite Laterals Accessory Allows 3" higher or lower pad position relative to attachment slot for user's left/right when mounted up or the user's right/left when mounted down OSALEB XS R or OSALEB XS L OSALEB S R or OSALEB XS L OSALEB M R or OSALEB M L OSALEB L L or OSALEB L R Offset Swing Away Lateral assembly (each) Extra Small Offset Swing Away Lateral assembly (each) Medium Extra Small Lateral Pad 3.25" x 4.25"(each) Offset Swing Away Lateral assembly (each) Small Small Lateral Pad 3.5" x 5.25"(each) Offset Swing Away Lateral assembly (each) Large Medium Lateral Pad 3.75" x 5.75"(each) Large Lateral Pad 4.25" x 6.5"(each) $200 $200 $200 $ Citation Drive, Unit 1 7, Concord, ON L4K 3C1 13 of 18 Tel: Fax:

14 Matrx Headrests MATRX SEATING SERIES Headrests come with standard fixed mounting hardware, knob style mounting plate and 1/4" shim. Accessory Multi Axis Hardware with Matrx Soft PHRK Matrx 10" Soft Pad Headrest Kit $395 Pad Headrest Upgradeable Hardware Select upgradeable hardware as a replacment to standard fixed headrest hardware. (Not available with the Onyx Headrest Pad or Matrx Soft Pad Accessory MAHU Multiaxis Hardware Depth & Height Adjustable through $210 horizontal slide bar. Dual pivot balls MSP Matrx 10" soft headrest Soft Pad Only $220 Additional Accessories Accessory EHRA S Elite Headrest Adapter Small For attachment of headrests to Elite Backs 12" wide $35 EHRA M Elite Headrest Adapter Medium For attachment of headrests to Elite Backs 13" 17" wide $35 For attachment of headrests to Elite EHRA L Elite Headrest Adapter Large Backs 18" 20" wide and all Elite Heavy $35 Duty back models 84 Citation Drive, Unit 1 7, Concord, ON L4K 3C1 14 of 18 Tel: Fax:

15 Arm Accessories MATRX SEATING SERIES Accessory MPA D Multi Position Arm Pad (each) Desk Length $85 MPA F Multi Position Arm Pad (each) Full Length $85 GAP N Gel Arm Pad (each) 2" x 12" GAP W Gel Arm Pad (each) 3.5" x 12" GAP L Gel Arm Pad (each) 3.5" x 14" $90 EAH R Ergonomic Arm Trough/ Hand Pad kit (each) User's Right $210 EAH L Ergonomic Arm Trough/ Hand Pad kit (each) User's Left $210 EAT R Ergonomic Arm Trough** (each) User's Right EAT L Ergonomic Arm Trough** (each) User's Left EHP Ergonomic Hand Pad*** (each) User's Right / Left $85 EMH For Motion Concepts Hand Pad $38 Arm Trough/Hand Pad Mounting Hardware EMO For Otto Bock Hand Pads $38 MACES Multi Axis Armrest Mount (each) Allows infinite adjustment of angle For use with EAH, EAT, GAP N, and rotation of arm pad and GAP W ** Does not include mounting hardware to connect to hand pad see EMH or see EAH L vs EAH R. ** For arm trough connecting hardware please order EMH or see EAH L vs EAH R for complete kit. 84 Citation Drive, Unit 1 7, Concord, ON L4K 3C1 15 of 18 Tel: Fax:

16 Hardware MATRX SEATING SERIES Hardware BDH0 Base Drop Hooks (per pair) Flushmount(0") drop for 7/8" or 1" diameter $27 BDH1 78 1" drop for 7/8" diameter $27 Base Drop Hooks (per pair) BDH2 78 2" drop for 7/8" diameter $27 BDH1 1 1" drop for 1" diameter $27 Base Drop Hooks (per pair) BDH2 1 2" drop for 1" diameter $27 PBMH Posture Back Mounting Hardware (per Complete Mounting assembly for pair) Posture Back or Elite Back * PBMH Q Posture Back Mounting Hardware (per Complete Mounting assembly for pair) Posutre Back or Elite Back 1 1/8" back * PBMH L Large Posture Back Mounting Hardware Complete Mounting assembly for (per pair) Posutre Back with 1 1/4" back canes SMH Split Mounting Hardware (per pair) Split Mounting hardware assembly for Posture Back or Elite Back. * HDMH Heavy Duty PB Mounting Hardware(per Mounting Hardware Assembly for pair) Heavy Duty Posture Back $325 PBCR Posture Back Cane Replacement (per pair) 1" dia. back cane replacement kit $115 FSSH Fixed Space Saver Hardware Allows fixed, non removable mounting of Elite back or Posture * BDC DuraClip (per pair) Top lock retractable hardware for use with drop hooks $60 BFC FixClip (per pair) Top lock hardware for use with drop hooks $25 EHRA S Elite Headrest Adapter Small For use with 12" Elite Back $35 EHRA M Elite Headrest Adapter Medium For use with 13" 17" Elite Back $35 For attachment of headrests to Elite EHRA L Elite Headrest Adapter Large Backs 18" 20" wide and all Elite Heavy $35 Duty back models EMP Extended Mounting Pins Elite or Posture Back to be installed on wheelchairs that are 2" wider than $40 *Not available on Heavy Duty Backs, weight capacity up to 300 lbs. 84 Citation Drive, Unit 1 7, Concord, ON L4K 3C1 16 of 18 Tel: Fax:

17 MATRX SEATING SERIES Genera Back New and Improved 2 Point Mounting hardware. Fits 3/4", 7/8" and 1" diameter back canes. Weight capacity up to 250 lbs. Fits Wheelchair Back Extra Outer Cover Width Height Back Extra Outer Cover GB1616 GBC $395 $95 GB1620 GBC $395 $95 GB1816 GBC $395 $95 GB1820 GBC $395 $95 GB2016 GBC $395 $95 GB2020 GBC $395 $95 84 Citation Drive, Unit 1 7, Concord, ON L4K 3C1 17 of 18 Tel: Fax:

18 Matrx Mx1 Back MATRX SEATING SERIES Carbon fiber back with three options of hardware. Weight Capacity of 114 kg/ 250lbs. Fits Wheelchair Back Extra Outer Cover Width Height Back Extra Outer Cover (HARDWARE IS NOT INCLUDED SELECT BELOW) IMX11409 NH IMX1C " 9 " $950 $170 IMX11162 NH IMX1C " 12 " $1,050 $170 IMX11416 NH IMX1C " 16 " $1,150 $170 IMX11509 NH IMX1C " 9 " $950 $170 IMX11512 NH IMX1C " 12 " $1,050 $170 IMX11516 NH IMX1C " 16 " $1,150 $170 IMX11609 NH IMX1C " 9 " $950 $170 IMX11612 NH IMX1C " 12 " $1,050 $170 IMX11616 NH IMX1C " 16 " $1,150 $170 IMX11709 NH IMX1C " 9 " $950 $170 IMX11712 NH IMX1C " 12 " $1,050 $170 IMX11716 NH IMX1C " 16 " $1,150 $170 IMX11809 NH IMX1C " 9 " $950 $170 IMX11812 NH IMX1C " 12 " $1,050 $170 IMX11816 NH IMX1C " 16 " $1,150 $170 Accessory RGDMT 23 RGDMT 30 RGDMT 41 FBCMT RBCMT Rigidizer Mount for 22.8 cm back Rigidizer Mount for 30.5cm back Rigidizer Mount for 40.6cm back Fixed Cane Mount (pair) Removable Cane Mount (pair) Includes hardware for 3/4" (20mm) cane diameter Includes hardware for 3/4" (20mm) cane diameter Includes hardware for 3/4" (20mm) cane diameter Includes hardware for 1" (25.5mm) cane diameter Includes hardware for 7/8" (22mm), 3/4" (20mm) and 1" (25.5mm) cane $195 $195 $195 $245 $270 BCO 22 Band Clamp Only (each) Clamp for 7/8" (22mm) cane diameter $8 BCO 19 BCO 26 SLMT 01 Band Clamp Only (each) Band Clamp Only (each) Mx1 SuperLite non adjustable, nonremovable hardware only Clamp for 3/4" (20mm) cane diameter Clamp for 1" (25.5 mm) cane diameter Includes hardware for 1" cane diameter $8 $8 $ Citation Drive, Unit 1 7, Concord, ON L4K 3C1 18 of 18 Tel: Fax:

INVACARE MATRX SEATING SERIES US PRICE LIST EFFECTIVE MAY 2013 REV Cushion Extra Outer Cover Width Depth Cushion Extra Outer Cover

INVACARE MATRX SEATING SERIES US PRICE LIST EFFECTIVE MAY 2013 REV Cushion Extra Outer Cover Width Depth Cushion Extra Outer Cover Matrx Vi Cushion Matrx Vi Cushions include inner & outer covers. Additional Extra covers are also available. Weight Capacity up to 300 lbs. Fits Wheelchair Cushion Extra Outer Cover Width Depth Cushion

More information

SEATING SERIES PRODUCT GUIDE

SEATING SERIES PRODUCT GUIDE SEATING SERIES PRODUCT GUIDE Invacare Matrx Seating and Positioning is an established global leader, committed to product innovation, high quality standards and superior product performance. As the world

More information

SEATING SERIES PRODUCT GUIDE

SEATING SERIES PRODUCT GUIDE C A N A D A SEATING SERIES PRODUCT GUIDE Invacare Matrx Seating and Positioning is an established global leader, committed to product innovation, high quality standards and superior product performance.

More information

REVERSIBLE OUTER COVER: >PELVIC OBLIQUITY KIT

REVERSIBLE OUTER COVER: >PELVIC OBLIQUITY KIT POSTURE SEAT MaTRx PS cushion is designed to provide superior positioning, stability and comfort. The design features an anatomically contoured shape with a unique waffled ischial relief recess, and an

More information

Standard Base Price : 2,950. Standard Features

Standard Base Price : 2,950. Standard Features Power Wheelchair Retail Prescription Form PRONTOM41PP010716 Tel: 01656 776222 Fax: 01656 776220 JULY 2016 Email: ordersuk@invacare.com Online Spares available at: www.invacare.co.uk Customer Ref : Account

More information

Seating Catalogue. Invacare Australia and New Zealand

Seating Catalogue. Invacare Australia and New Zealand Seating Catalogue Invacare Australia and New Zealand 125 years of experience Invacare is the world s leading manufacturer of home healthcare and mobility equipment. We proudly supply Australian and New

More information

seating Invacare matrx

seating Invacare matrx SEATING SERIES Invacare matrx seating series With the number of new seating and positioning products available today, it is only natural to choose the best known products. Invacare Corporation and Motion

More information

Multi-Position Standing(MPS) System US PRICE LIST AND ORDER FORM Effective July 1, 2012

Multi-Position Standing(MPS) System US PRICE LIST AND ORDER FORM Effective July 1, 2012 Multi-Position Standing(MPS) System US PRICE LIST AND ORDER FORM Effective July 1, 2012 Date of Order: Dealer Name: Dealer Account #: PO #: Base MFR. PO #: Tag: Purchasing Contact: Phone: Fax: RTS/Therapist:

More information

NAME PHONE NO ACCOUNT# P.O. DATE ADDRESS

NAME PHONE NO ACCOUNT# P.O. DATE ADDRESS FRAME SELECTION FRAME TYPE Seat angle is set at 3 degrees. See service manual for details. PATRIOT Folding Frame w/swingaway Front End $1,345 FRAME WIDTH W14 14'' Wide No Charge Not available with 18"

More information

ELITE HEAVY-DUTY BACK

ELITE HEAVY-DUTY BACK WARRANTY Every Matrx Elite HD back is carefully inspected and tested to provide optimum performance. Each back is guaranteed to be free from defects for a period of 24 months from the date of purchase,

More information

Accessories brochure

Accessories brochure Accessories brochure NEW The Invacare Rea Passive range, with its tilt and recline chairs is compatible with a wide variety of accessories, giving users the opportunity to achieve an optimal fit, and greater

More information

Invacare REA Azalea Transit RETAIL Max User Weight 135Kg (21 stone)

Invacare REA Azalea Transit RETAIL Max User Weight 135Kg (21 stone) Manual Wheelchair Retail Prescription Form ReaAzaleaTransit281117 Tel: 01656 776222 Fax: 01656 776220 Email: ordersuk@invacare.com January 2018 Online spares available at: www.invacare.co.uk Customer Ref:

More information

Invacare Kite (Modulite Flex3 Seating System) Dealer Max User Weight 160Kg (25 stone)

Invacare Kite (Modulite Flex3 Seating System) Dealer Max User Weight 160Kg (25 stone) Invacare Ltd Power Prescription Form Pencoed Technology Park Dealer Prescription Form Pencoed CF35 5AQ LPF1U2KITEFLEX011015Dealer Tel: +44 (0) 1656 776222 Fax: +44 (0) 1656 776220 July 2015 email: ordersuk@invacare.com

More information

ULTRA TDX 2. Retail Order Form Max user weight 136kg (21.4 stone) Featuring

ULTRA TDX 2. Retail Order Form Max user weight 136kg (21.4 stone) Featuring TDX 2 ULTRA Retail Order Form Max user weight 136kg (21.4 stone) Featuring lass leading shear reduction C with our ESR Mechanism chieve the perfect fit with simple A and precise adjustment features Maximise

More information

USA CANADA.

USA CANADA. CANADA Motion Concepts 84 Citation Dr., Unit 1-7 Concord, ON L4K 3C1 Toll Free Tel: 1.866.748.7943 Tel: 905.695.0134 Fax: 905.695.0138 USA Motion Concepts 700 Ensminger Rd., Suite 112 Tonawanda, NY 14150

More information

FUZE T50. Order Form USA. Please send your completed order form by to or by fax to

FUZE T50. Order Form USA. Please send your completed order form by  to or by fax to Page 1 of 5 Purchase Order Tag Dealer/Organization Name Purchaser Name and Contact Information Mailing Address Shipping Address Please send your completed order form by email to info@pdgmobility.com or

More information

FUZE T20. Order Form - USA Prices in U.S. Dollars. January 1, C u s t o m e r a n d O r d e r I n f o r m a t i o n.

FUZE T20. Order Form - USA Prices in U.S. Dollars. January 1, C u s t o m e r a n d O r d e r I n f o r m a t i o n. C u s t o m e r a n d O r d e r I n f o r m a t i o n Purchase Order * Tag v.070118 Dealer/Provider Name * Purchaser Name and Contact Information * Billing Address * Shipping Address * * required F r a

More information

INDUSTRIES, INC. PRODUCT CATALOG C121

INDUSTRIES, INC. PRODUCT CATALOG C121 METALCRAFT INDUSTRIES, INC. Note About Digital Catalog Note About Digital Catalog Text In This Digital Catalog That Are Highlighted Are Linked To Other Parts Of The Highlighted Text In This Digital Catalog

More information

Invacare FOX (Modulite Seating System) Retail Max User Weight 127Kg (20 stone)

Invacare FOX (Modulite Seating System) Retail Max User Weight 127Kg (20 stone) Power Wheelchair Retail Prescription Form FOXMOD210917 Tel: 01656 776222 Fax: 01656 776220 Email: ordersuk@invacare.com Online Spares available at: www.invacare.co.uk OCTOBER 2017 Customer Ref : Account

More information

TRD0359 REV A - Parts Manual 2015 DCN-1363, JAN 09, 2015 HEADREST & MOUNTING HARDWARE

TRD0359 REV A - Parts Manual 2015 DCN-1363, JAN 09, 2015 HEADREST & MOUNTING HARDWARE HEADREST & MOUNTING HARDWARE Product/Device Description: s Device Master Record Document No. DMR-4 Document Rev. A Page of 0 Device No.: D-070. Purpose This record contains references to all top level

More information

Positioning Components Order Form - ODJFS Only

Positioning Components Order Form - ODJFS Only Quantum Rehab 401 York Ave., Duryea, PA 18642 Phone: 866-800-2002 Fax: 866-707-3422 Email: quantumorders@pridemobility.com Positioning Components Order Form - ODJFS Only Account Number: Date: Provider

More information

For the Modulite Teen seating please select the underlined options on this form and include a completed Modulite Teen Seating form

For the Modulite Teen seating please select the underlined options on this form and include a completed Modulite Teen Seating form Power Wheelchair Retail Prescription Form BORAMOD111217 Tel: 01656 776222 Fax: 01656 776220 JANUARY 2018 Email: ordersuk@invacare.com Online Spares available at: www.invacare.co.uk Customer Ref : Account

More information

Parts Catalog Issued: May 12, Seating and Positioning

Parts Catalog Issued: May 12, Seating and Positioning Parts Catalog Issued: May 1, 015 Seating and Positioning Parts Catalog Usage Guide The information contained in this document is subject to change without notice. This catalog contains service parts for.

More information

STELLAR. Order Form - USA Prices in U.S. Dollars. January 1, C u s t o m e r a n d O r d e r I n f o r m a t i o n.

STELLAR. Order Form - USA Prices in U.S. Dollars. January 1, C u s t o m e r a n d O r d e r I n f o r m a t i o n. C u s t o m e r a n d O r d e r I n f o r m a t i o n Purchase Order * Dealer/Provider Name * Purchaser Name and Contact Information * Billing Address * Tag v.072318 Shipping Address * * required F r a

More information

Note Section. Set-to-Spec. This section must be filled out, otherwise the selection will default to the mid-range measurements.

Note Section. Set-to-Spec. This section must be filled out, otherwise the selection will default to the mid-range measurements. AADL W659/W991 Quantum Q6 Edge Z with TB3 Power Positioning FOR AADL USE ONLY Pride Mobility Products Co. 5096 South Service Rd, Beamsville, ON, L0R 1B3 Phone: 888-570-1113 Fax: 866-514-1303 Discount:

More information

FUZE T50. Order Form - USA Prices in U.S. Dollars. January 1, C u s t o m e r a n d O r d e r I n f o r m a t i o n.

FUZE T50. Order Form - USA Prices in U.S. Dollars. January 1, C u s t o m e r a n d O r d e r I n f o r m a t i o n. C u s t o m e r a n d O r d e r I n f o r m a t i o n Purchase Order * Dealer/Provider Name * Purchaser Name and Contact Information * Billing Address * Tag v.070118 Shipping Address * * required F r a

More information

x:panda, size 1, med. back X c x:panda, size 1, med. seat 7¼" X c

x:panda, size 1, med. back X c x:panda, size 1, med. seat 7¼ X c Account No. Drop Ship: Date: Name P.O. Number: Address Buyer: City Marked For: State Zip E Mail: Tel. Fax Features included in standard price: Height, Depth & Angle Adjustable Back Angle Adjustable Adduction

More information

STELLAR GL. Order Form - USA Prices in U.S. Dollars. January 1, C u s t o m e r a n d O r d e r I n f o r m a t i o n.

STELLAR GL. Order Form - USA Prices in U.S. Dollars. January 1, C u s t o m e r a n d O r d e r I n f o r m a t i o n. C u s t o m e r a n d O r d e r I n f o r m a t i o n Purchase Order * Dealer/Provider Name * Purchaser Name and Contact Information * Billing Address * Tag v.070118 Shipping Address * * required F r a

More information

Gives useful tips, recommendations and information for efficient, trouble-free use.

Gives useful tips, recommendations and information for efficient, trouble-free use. User Manual DEALER: This manual MUST be given to the user of the product. USER: BEFORE using this product, read this manual and save for future reference. Invacare Matrx PB 1 General 1.1 Symbols Signal

More information

SEATING CHOICE TITANIUM FRONT FRAME

SEATING CHOICE TITANIUM FRONT FRAME Manual Wheelchair Retail Prescription Form Champion140618 Tel: 01656 776222 Fax: 01656 776220 Email: ordersuk@invacare.com Online spares available at: www.invacare.co.uk July 2018 Account No : Contact

More information

Matrx Back Interface for the

Matrx Back Interface for the Matrx Back Interface for the Quantum Tru-Balance 3 Seating System Installation Instructions TRD0357, Rev A Important Symbols in this Manual Setting up and operating your wheelchair safely depends on your

More information

Featuring. Customer Ref: TDX2 Ultra

Featuring. Customer Ref: TDX2 Ultra Featuring Class leading shear reduction with our ESR Mechanism Achieve the perfect fit with simple and precise adjustment features Maximise comfort and pressure relief with the advanced tilt and recline

More information

OBSS/ Tru Shape Packages

OBSS/ Tru Shape Packages Account Information Date Patient First Name Phone Number Email Address Account Number Last Name Fax Number Primary Contact OBSS/ Tru Shape Packages Order Form Effective Date 09/01/2017 P.O. Number Ship

More information

R82 x:panda. USD Retail Price List/ Order Form. Account #: Purchase Order No.:

R82 x:panda. USD Retail Price List/ Order Form. Account #: Purchase Order No.: Account #: Purchase Order No.: Contact: R82 x:panda USD Retail Price List/ Order Form Date: Mark For: Bill To: Address: City/State/Zip: Phone: Email Ship To: Address: City/State/Zip: Phone: US Configuration

More information

Bora. Standard Base Price 4,100. Standard Features SEAT DEPTHS

Bora. Standard Base Price 4,100. Standard Features SEAT DEPTHS Power Wheelchair Retail Prescription Form BORAMOD121218 Tel: 01656 776222 Fax: 01656 776220 JANUARY 2019 Email: ordersuk@invacare.com Online Spares available at: www.invacare.co.uk Customer Ref : Account

More information

BENTLEY. 15" Seat Width 18" Seat Width. Requires Heavy Duty Base and Seat Frame. Extended delivery lead times may apply.

BENTLEY. 15 Seat Width 18 Seat Width. Requires Heavy Duty Base and Seat Frame. Extended delivery lead times may apply. C u s t o m e r a n d O r d e r I n f o r m a t i o n Purchase Order * Dealer/Provider Name * Purchaser Name and Contact Information * Billing Address * Tag v.072318 Shipping Address * * required F r a

More information

Please make your selection with a cross in the box Standard feature Free of Charge

Please make your selection with a cross in the box Standard feature Free of Charge Manual Wheelchair Retail Prescription Form Champion161116 Tel: 01656776222 Fax: 01656776220 Email: ordersuk@invacare.com Online spares available at: www.invacare.co.uk JANUARY 2017 Account No : Built in

More information

FUSION Seating Prescription Form Custom Built Seating System

FUSION Seating Prescription Form Custom Built Seating System GENERAL INFORMATION Clinician: Email: Date: Service: Delivery Address: Client Name/Ref: Address/School: Current Equipment: Issues with Current Equipment: Observations, deformity: Hips/Pelvis: Spine/Trunk:

More information

R82 x:panda. USD Retail Price List/ Order Form. Account #: Purchase Order No.:

R82 x:panda. USD Retail Price List/ Order Form. Account #: Purchase Order No.: Account #: Purchase Order No.: Contact: R82 x:panda USD Retail Price List/ Order Form Date: Mark For: Bill To: Address: City/State/Zip: Phone: Email Ship To: Address: City/State/Zip: Phone: US Configuration

More information

SpectraXTR2 HD (Modulite Flex 3 Seating or MAX System) Dealer Max User Weight 160Kg (25 stone)

SpectraXTR2 HD (Modulite Flex 3 Seating or MAX System) Dealer Max User Weight 160Kg (25 stone) Invacare Ltd Power Chair Prescription Form Pencoed Technology Park Dealer Prescription Form Pencoed CF35 5AQ LPF1U2SPECTRAXTR2HD010715DEALER Tel: +44 (0) 1656 776222 Fax: +44 (0) 1656 776220 July 2015

More information

FUZE T20. Order Form - Canada Prices in Canadian Dollars. January 1, C u s t o m e r a n d O r d e r I n f o r m a t i o n.

FUZE T20. Order Form - Canada Prices in Canadian Dollars. January 1, C u s t o m e r a n d O r d e r I n f o r m a t i o n. C u s t o m e r a n d O r d e r I n f o r m a t i o n Purchase Order * Dealer/Provider Name * Purchaser Name and Contact Information * Billing Address * Tag v.070118 Shipping Address * * required F r a

More information

Product List V Adaptive Engineering Lab 102 E Keefe Ave Milwaukee, WI 53212

Product List V Adaptive Engineering Lab 102 E Keefe Ave Milwaukee, WI 53212 Product List V2016.1 Adaptive Engineering Lab 102 E Keefe Ave Milwaukee, WI 53212 P: 866.656.1486 F: 866.656.1487 E: sales@aelseating.com W: AELseating.com Published August 1, 2016 TABLE OF CONTENTS >Positioning

More information

Standard Base Price: 618

Standard Base Price: 618 Manual Wheelchair Retail Prescription Form ACTION4NGHD11112016 Tel: 01656 776222 Fax: 01656 776220 JAN 2017 Email: ordersuk@invacare.com Online Spares available at: www.invacare.co.uk Customer Ref: Contact

More information

M1 - NPO. Dealer Information. Client Information. Client Measurements

M1 - NPO. Dealer Information. Client Information. Client Measurements Dealer Information * Contact: Dealer Code: * Dealer Name: Address: * City: * Province: * Phone#: * Fax#: PO#: Email Address: Client Information Permobil recommends that the client is evaluated by a certified

More information

i IMPORTANT! The installation instructions contained in this manual should only be carried out by a qualified technician. INSTALLATION/USER MANUAL

i IMPORTANT! The installation instructions contained in this manual should only be carried out by a qualified technician. INSTALLATION/USER MANUAL i IMPORTANT The installation instructions contained in this manual should only be carried out by a qualified technician. INSTALLATION/USER MANUAL i IMPORTANT TRANSPORTING THE CLIENT WITHIN A WHEELCHAIR

More information

STELLAR. 15" Seat Width 18" Seat Width. Requires Heavy Duty Base and Seat Frame. Extended delivery lead times may apply.

STELLAR. 15 Seat Width 18 Seat Width. Requires Heavy Duty Base and Seat Frame. Extended delivery lead times may apply. C u s t o m e r a n d O r d e r I n f o r m a t i o n Purchase Order * Dealer/Provider Name * Purchaser Name and Contact Information * Billing Address * Tag v.072318 Shipping Address * * required F r a

More information

Support Harness Mounting Bracket Assembly for the

Support Harness Mounting Bracket Assembly for the Support Harness Mounting Bracket Assembly for the Matrx PB and Matrx Elite Back Cushion Installation & Set-up Manual DEALER: This manual contains important Safety, Installation and Set-up information specific

More information

cp tech customised product technology Product Catalogue

cp tech customised product technology Product Catalogue cp tech customised product technology Product Catalogue CONTENTS 1. How to Measure a Postural Insert 2. Insert Components - Back and Base - Cushions - Lateral Supports - Head Supports - Pommels - Foot

More information

q q q q q q q q q q q q q q q q q q Frame q Titanium Frame K5-CAT5-TITAN $ Includes hangers and base frame. Does not include Cross Braces.

q q q q q q q q q q q q q q q q q q Frame q Titanium Frame K5-CAT5-TITAN $ Includes hangers and base frame. Does not include Cross Braces. Funder: Order Number: Date: q Quote q PO Number: Therapist: Marked For: Catalyst 5 K5-CAT5-ALI 136kg weight capacity Frame Seat Width / Seat Depth Select box corresponding to desired Seat Width and Depth

More information

BENTLEY. Order Form - AADL - W322 Prices in Canadian Dollars. October 1, W h e e l L o c k s. A n t i - T i p p e r s. B a c k P o s t S t y l e

BENTLEY. Order Form - AADL - W322 Prices in Canadian Dollars. October 1, W h e e l L o c k s. A n t i - T i p p e r s. B a c k P o s t S t y l e C u s t o m e r a n d O r d e r I n f o r m a t i o n Purchase Order * Tag Dealer/Provider Name * Purchaser Name and Contact Information * Billing Address * Shipping Address * * required F r a m e T y

More information

FOR AADL ONLY COMFORT MATE EXTRA CUSHIONS

FOR AADL ONLY COMFORT MATE EXTRA CUSHIONS COMFORT MATE EXTRA CUSHIONS FOR AADL ONLY Invacare Rehab Seating and Positioning Products Suggested Canadian List Price Effective March 2nd, 2009 Revised July 1st, 2013 *UPDATED - DENOTES CHANGES CMEX66

More information

Account Number: Provider Name: Contact Name: Phone #: Fax #: Address: Taken By: Client Height: Client Weight:

Account Number: Provider Name: Contact Name: Phone #: Fax #:  Address: Taken By: Client Height: Client Weight: Quantum 1450 Group 3 Single Power Order Form Up To 600lbs Weight Capacity Quantum Rehab A Division of Pride Mobility Products Corporation 182 Susquehanna Ave., Exeter, PA 18643 Phone: (866)800-2002 Fax:

More information

Invacare Action 3 NG Transit Retail Max User Weight 125Kg (19.7 stone)

Invacare Action 3 NG Transit Retail Max User Weight 125Kg (19.7 stone) Manual Wheelchair Retail Prescription Form ACTION3NGTRANSIT10112016 Tel: 01656 776222 Fax: 01656 776220 JAN 2017 Email: ordersuk@invacare.co.uk Online Spares available at www.invacare.co.uk Customer Ref:

More information

Pride Mobility Products Corporation 182 Susquehanna Ave., Exeter, PA Sales: Phone: (866) Fax: (866)

Pride Mobility Products Corporation 182 Susquehanna Ave., Exeter, PA Sales: Phone: (866) Fax: (866) This product is available for purchase online at www.mypride.com Account #: Date: Order No. Fax No. Phone No. PAGE 1 Pride Mobility Products Corporation 182 Susquehanna Ave., Exeter, PA 18643 Sales: Phone:

More information

Order Date : k-series. titanium. Please make your selection with a cross in the box Standard feature Free of Charge

Order Date : k-series. titanium. Please make your selection with a cross in the box Standard feature Free of Charge Manual Wheelchair Retail Prescription Form KSeriesTitanium040516 Tel: 01656 776222 Fax: 01656 776220 Email: ordersuk@invacare.com July 2016 Online spares available at: www.invacare.co.uk Customer Ref:

More information

Black -01 Moss green -95 Yellow -99. Heather purple -97. Indicate height. Indicate height. Indicate angle. Indicate height: cm. Indicate height: cm

Black -01 Moss green -95 Yellow -99. Heather purple -97. Indicate height. Indicate height. Indicate angle. Indicate height: cm. Indicate height: cm Cross 5 XL Prescription form 75188K 017-05-08 Reference: Name: Tel: Date: version is marked with The measurements given can vary ±% Short frame Seat width (cm) Seat depth 36-4 (-49*)cm Measured from back

More information

MASS Script Form. Frame. Backrest. Seat Depth. Tsunami ALX K0005 Charge. Sling Position. Seat Width / Seat Depth. Seat Width.

MASS Script Form. Frame. Backrest. Seat Depth. Tsunami ALX K0005 Charge. Sling Position. Seat Width / Seat Depth. Seat Width. MASS Script Form Company: Account Number: Date: Quote PO Number: RTS: Marked For: Australian Order Form Effective 05/07/2014 Ship To: Address: City: State: Zip: Phone: Email/Fax: Tsunami ALX K0005 Charge

More information

Frame. Pos Item number Description Comment

Frame. Pos Item number Description Comment Titel - 1 - Titel - 2 - Table of Content Zippie Voyage... 4 Basic Equipment... 4 Frame... 4 Slide-N-Lock Interface... 5 Transit Kit... 6 Canopy... 7 Seat, Back... 8 Seat Base... 8 Seatback... 10 Seat Cushion...

More information

CUSTOM INCEPTION CUSHION ORDER FORM HCPC CODE: E2609

CUSTOM INCEPTION CUSHION ORDER FORM HCPC CODE: E2609 CUSTOM INCEPTION CUSHION ORDER FORM HCPC CODE: E2609 CUSTOMER/PATIENT INFORMATION Date: Company Name/ACCT #: Patient Name: Patient Weight: Patient Height: P.O. Number: Requested By: Phone: Email: Ship

More information

Note Section. Set-to-Spec. This section must be filled out, otherwise the selection will default to the mid-range measurements.

Note Section. Set-to-Spec. This section must be filled out, otherwise the selection will default to the mid-range measurements. AADL W592/W991 Quantum Q6 Edge 2.0 with TB3 Power Positioning FOR AADL USE ONLY Pride Mobility Products Co. 5096 South Service Rd, Beamsville, ON, L0R 1B3 Phone: 888-570-1113 Fax: 866-514-1303 Discount:

More information

Küschall Ultra Light RETAIL Maximum user weight 130kg (20.5 Stone)

Küschall Ultra Light RETAIL Maximum user weight 130kg (20.5 Stone) Manual Wheelchair Retail Prescription Form UltraLight061216 Tel: 01656776222 Fax: 01656776220 Email: ordersuk@invacare.com JANUARY 2017 Online spares available at: www.invacare.co.uk Account No : Built

More information

Convaid Trekker 2 - HCPCS E1234 Retail Price List / Order Form

Convaid Trekker 2 - HCPCS E1234 Retail Price List / Order Form Account #: Contact: Retail Price List / Order Form Purchase Order #: Date: Mark For: Bill To: Address: City/State/Zip: Phone: Email: Ship To: Address: City/State/Zip: Phone: TR14 Base Accepts TR12 & TR14

More information

ICON BACK SYSTEM featuring VariLock hardware

ICON BACK SYSTEM featuring VariLock hardware LAYHUGLAUGHTRAVELDANCELOVES ORKSIT LIVERELAXEXPERIENCEROLLSHOP ICON BACK SYSTEM featuring VariLock hardware Icon Back System Innovation, Versatility & Comfort For many wheelchair users, a solid back system

More information

ICON Back System. Product Training. Icon Back System

ICON Back System. Product Training. Icon Back System ICON Back System Product Training Innovation Versatility Comfort Simplicity Easy to Use Features and Models Available in 4 models Icon Low Back Icon Mid Back Icon Tall Back Icon Deep Back New design Hardware

More information

Basic price 2.250,- Excl. VAT

Basic price 2.250,- Excl. VAT Date Invoice address Invoice address = delivery address Customer code C- Contact person Reference Other delivery address Quote Seat width D64035 35 cm D64040 40 cm D64045 45 cm D64050 50 cm = Standard

More information

MASS Script Form. 160 Kg Weight Capacity Charge. Transit Option. 136 Kg maximum weight capacity. Not available with Removable Seat Pan.

MASS Script Form. 160 Kg Weight Capacity Charge. Transit Option. 136 Kg maximum weight capacity. Not available with Removable Seat Pan. MASS Script Form Australian Order Form Effective 05/07/2014 Company: Account Number: Date: Quote PO Number: RTS: Marked For: Ship To: Address: City: State: Zip: Phone: Email/Fax: Catalyst 5Vx K0005 Charge

More information

I C O N hug ski r aft climb shop Ventu

I C O N hug ski r aft climb shop Ventu layswimskidanceclimbraceventu ovehugcryrafthikeworkshopea ICON BACK SYSTEM L I F E I S C A L L I N G Icon back system Innovation, Versatility, Comfort For many wheelchair users, a solid back system is

More information

Quick Reference J3 Back Guide

Quick Reference J3 Back Guide Quick Reference J3 Back Guide OVERVIEW STEP 1 Conur Depth For a cusm-fit J3 Backrest, follow this 5-Step Guide determine your J3 Smart Part Number. STEP 2 Level of Support STEP 3 Back Support Height STEP

More information

NAME PHONE NO ACCOUNT # P.O. DATE ADDRESS

NAME PHONE NO ACCOUNT # P.O. DATE ADDRESS Print Form Save Form Submit Form Clear Form Contents Invacare TDX SP Rehab Seat Power Wheelchair Suggested Canadian Price List Effective July 25, 2017 NAME PHONE NO ACCOUNT # P.O. DATE ADDRESS BASE CHAIR

More information

Photo: Virginie Beauchamp

Photo: Virginie Beauchamp Product Catalogue 1 2 Photo: Virginie Beauchamp BACKREST (ONE PIECE) Description: Single-piece backrest for upper-body positioning Sturdy aluminium back plate High quality cushion cover 4 mounting points

More information

Convaid Trekker 2 - HCPCS E1234 Canadian Retail Price List / Order Form

Convaid Trekker 2 - HCPCS E1234 Canadian Retail Price List / Order Form Account #: Contact: Canadian Retail Price List / Order Form Purchase Order #: Date: Mark For: Bill To: Address: City/State/Zip: Phone: Email: Ship To: Address: City/State/Zip: Phone: TR14 Base Accepts

More information

4.2 HELIO KIDS MODEL. Ultralight Folding Carbon Fiber HELIO KIDS Wheelchair Including angle & depth adjustable back (79 kg lbs weight capacity)

4.2 HELIO KIDS MODEL. Ultralight Folding Carbon Fiber HELIO KIDS Wheelchair Including angle & depth adjustable back (79 kg lbs weight capacity) 519, J-Oswald Forest, suite 101 Saint-Roch-de-l'Achigan, QC, Canada J0K 3H0 T.450 588-6555 1 866 650-6555 F.450 588-0200 www.motioncomposites.com Account : PO : Vendor : CUSTOM TECHNOLOGIES LIMITED Date

More information

LOVEHUGCRYRAFTHIKEWORKSHOPEAT

LOVEHUGCRYRAFTHIKEWORKSHOPEAT Cushion Composition Shell Composition Hardware Composition A Division of Cascade Designs, Inc. 4000 1st Avenue South Seattle, WA 98134 Phone: (800) 827-4548 Fax: (206) 343-5795 www.varilite.com ICON LOW

More information

Bariatric Folding Wheelchair - Minimaxx & Disc

Bariatric Folding Wheelchair - Minimaxx & Disc 2 2 Bariatric Equipment Folding Wheelchair Portering Chair Mobile Commode Shower Chairs Shower Chair & Commode Pa ent & High Back Chair Four Leg & Can lever Chair Rollator Walker & Training Suit 4 6 7

More information

Adjustable Height Raised Toilet Seat Model 101 RTS Pricelist/Order Form December 2014

Adjustable Height Raised Toilet Seat Model 101 RTS Pricelist/Order Form December 2014 Adjustable Height Raised Toilet Seat Model 101 RTS Date: Name: P.O.#: Address: Name: City/State/Zip: Mark For: Phone: Account #: Fax: This Activeaid raised toilet seat is unique in its design to accommodate

More information

Invacare Series ContourU Model #'s CM01S, CM01B, CM02S, CM02B

Invacare Series ContourU Model #'s CM01S, CM01B, CM02S, CM02B Invacare Series ContourU Model #'s CM01S, CM01B, CM02S, CM02B For 3D Image Systems: E-mail Order Form and Digitized File to: ElyriaCustomSeating@invacare.com Company Name: Date: Account #: Contact Name:

More information

JIVE F/R: 5,650 9,193 JIVE M: 5,895 9,591

JIVE F/R: 5,650 9,193 JIVE M: 5,895 9,591 Invoice to: Deliver to: Name: Name: Street: Street: Town: Postal code: Town: Postal code: Country: Country: Tel: Fax: Tel: Fax: Order date: Marked for: Purchase order: Standard Features Angle adj. footplate

More information

User Manual. Invacare Matrx Genera Back. Model Number GB. 1 General

User Manual. Invacare Matrx Genera Back. Model Number GB. 1 General User Manual DEALER: This manual MUST be given to the user of the product. USER: BEFORE using this product, read this manual and save for future reference. Invacare Matrx Genera Back Model Number GB 1 General

More information

Mx1 SuperLite Mount. Back Cushion. Installation/User Manual

Mx1 SuperLite Mount. Back Cushion. Installation/User Manual Mx1 SuperLite Mount Back Cushion Installation/User Manual DEALER: This manual contains important safety, Installation and Set-up information specific to the Invacare Matrx Mx1 SuperLite Mount Back. This

More information

Rodeo Upgrades Q2 2014

Rodeo Upgrades Q2 2014 Rodeo Upgrades Q2 2014 New Rodeo Convaid is excited to announce new standard features and accessory options on the Rodeo Tiltin-Space Wheelchair. All new orders received as of June 19 2014 will have all

More information

BREEZY EC WHEELCHAIRS. The best combination of durability, selection and value.

BREEZY EC WHEELCHAIRS. The best combination of durability, selection and value. BREEZY EC WHEELCHAIRS The best combination of durability, selection and value. Breezy EC 2000 A quality wheelchair with options offering the flexibility to accommodate a variety of users. Standard Features

More information

2016 EZ RIDER UPRIGHT PRODUCT PPT

2016 EZ RIDER UPRIGHT PRODUCT PPT 2016 EZ RIDER UPRIGHT PRODUCT PPT By Nancy Guzman 310.618.0111, Ext. 143 nancyg@convaid.com Product Overview EZ RIDER 10 Fixed Tilt Customizable Multiple Upholstery Styles & Colors 5 years of Growth Capabilities

More information

i NOTE: This installation manual contains important set-up and adjustment information. Please forward to the Dealer, together with the TRx system, in

i NOTE: This installation manual contains important set-up and adjustment information. Please forward to the Dealer, together with the TRx system, in Multi-Axis Armrest Mount Installation & Set-Up Manual i NOTE: This installation manual contains important set-up and adjustment information. Please forward to the Dealer, together with the TRx system,

More information

AT MSRP Price List. Description. HCPCS Code K0020 K0020 K0106 K0106. Part Number AP3 AP4 GAP GAPS 1386/87 FUA PT0031

AT MSRP Price List. Description. HCPCS Code K0020 K0020 K0106 K0106. Part Number AP3 AP4 GAP GAPS 1386/87 FUA PT0031 Client: P.O.#: AT MSRP List AP3 AP4 GAP GAPS 1386/87 FUA PT0031 3 x 12 Desk Length Leatherette 4 x 16 Tapered Leatherette Standard Height Adjustable, Removable Armrest Flip-Up Armrest Left $37.50/ea. $164.00/ea.

More information

Bariatric Folding Wheelchair - Minimaxx & Disc

Bariatric Folding Wheelchair - Minimaxx & Disc 4 Bariatric Equipment Folding Wheelchair Portering Chair Mobile Commode Shower Chairs Shower / Commode Chair Patient & High Back Chair Four Leg Chairs Rollator Walker & Training Suit 6 8 9 10 12 13 14

More information

R82 Stingray. CAD Retail Price List/ Order Form. Account #: Purchase Order No.: City/State/Zip: Effective: 2/01/ Rev 7.

R82 Stingray. CAD Retail Price List/ Order Form. Account #: Purchase Order No.: City/State/Zip: Effective: 2/01/ Rev 7. R82 Stingray CAD Retail Price List/ Order Form Account #: Purchase Order No.: Date: Contact: Mark For: Bill To: Address: City/State/Zip: Phone: Email Ship To: Address: City/State/Zip: Phone: US Configuration

More information

Print Form Save Form Submit

Print Form Save Form Submit Print Form Save Form Submit Clear Form Contents Invacare TDX SP-LE Maxx Rehab Seat Power Wheelchair Suggested Canadian Price List Effective June 1, 2017 DEALER : ACCOUNT#: DEALER CONTACT: PHONE #: P.O.

More information

Order Date : carbon. Tension adjustable seat, option DDA0611 is not possible with seat width 320mm

Order Date : carbon. Tension adjustable seat, option DDA0611 is not possible with seat width 320mm Manual Wheelchair Retail Prescription Form KSeriesCarbon061218 Tel: 01656 776222 Fax: 01656 776220 Email: ordersuk@invacare.com Online spares available at: www.invacare.co.uk January 2019 Customer Ref:

More information

Formula CG Tilt (CGT) Powered Seating

Formula CG Tilt (CGT) Powered Seating Parts Catalog Issued: Jan 8, 2018 Formula CG Tilt (CGT) Powered Seating For TDX SI Parts Catalog Usage Guide The information contained in this document is subject to change without notice. This catalog

More information

Please choose the seat width for accessories: 35 cm 40 cm 43 cm 45 cm 50 cm

Please choose the seat width for accessories: 35 cm 40 cm 43 cm 45 cm 50 cm Netti 4U comfort fully adjustable Date Invoice address Invoice address = delivery address Customer code C- Contact person Reference Other delivery address Offer Order Basic price: 2.750,- excl. VAT. Seat

More information

R82 Stingray - E1233

R82 Stingray - E1233 Account #: Purchase Order No.: Contact: R82 Stingray - E1233 USD Retail Price List/ Order Form Date: Mark For: Bill To: Address: City/State/Zip: Phone: Email Ship To: Address: City/State/Zip: Phone: US

More information

k-series Aluminium Standard Features

k-series Aluminium Standard Features Manual Wheelchair Retail Prescription Form KSeries200618 Tel: 01656 776222 Fax: 01656 776220 Email: ordersuk@invacare.com Online spares available at: www.invacare.co.uk July 2018 Customer Ref: Account

More information

Formula TRE Powered Seating

Formula TRE Powered Seating Parts Catalog Issued: Aug 2, 208 Formula TRE Powered Seating TDX Power Wheelchairs Parts Catalog Usage Guide The information contained in this document is subject to change without notice. This catalog

More information

Jupiter. Uncompromised comfort and postural support in keeping with a contemporary home setting

Jupiter. Uncompromised comfort and postural support in keeping with a contemporary home setting Jupiter Uncompromised comfort and postural support in keeping with a contemporary home setting Jupiter Jupiter is the ideal home use chair for children through to adults, that combines comfort with superior

More information

Account Number: Provider Name: Contact:

Account Number: Provider Name: Contact: Quantum Rehab Discount: Terms: Freight: Taken By: DME providers are responsible for determining appropriate billing codes when submitting for insurance reimbursement. HCPCS codes should not be considered

More information

Back. Ride Custom Back Order Form

Back. Ride Custom Back Order Form Back Client First and Last Name NOTE: This order form must be accompanied by a Ride Custom Seating Systems Face Sheet. Prices effective November 1, 2012. Ride Custom Back (Model #: RCB100) Medicare HCPCS

More information

Traxx 3 & Atigra 2 Script Form

Traxx 3 & Atigra 2 Script Form Traxx 3 & Atigra 2 Script Form Client Information Address Therapist Information Organisation Email Phone Height Weight Funding Source Salesperson Information Company Traxx 3 Atigra 2 Standard Features

More information

INSTALLATION/USERS MANUAL

INSTALLATION/USERS MANUAL INSTALLATION/USERS MANUAL ! IMPORTANT: The installation and set up instructions should be carried out by a qualified technician. IMPORTANT: It is important to refer to the wheelchair owner s manual for

More information

Invacare EXPRESS Manual Wheelchair Order Form Suggested Canadian Price List Effective October 30th, 2018

Invacare EXPRESS Manual Wheelchair Order Form Suggested Canadian Price List Effective October 30th, 2018 TRACER EX2 FOLDING WHEELCHAIRS Invacare EXPRESS Manual Wheelchair Order Form Suggested Canadian Price List Effective October 30th, 2018 PROVIDER NAME PHONE NO ACCOUNT # P.O. DATE ADDRESS Invacare Canada

More information

Adult Manual Wheelchairs. Etac Cross 5 Active. Creating stability for activity

Adult Manual Wheelchairs. Etac Cross 5 Active. Creating stability for activity Adult Manual Wheelchairs Etac Cross 5 Active Creating stability for activity Etac Cross 5 Active - Creating stability for activity Etac Cross 5 Active is the perfect choice for the active wheelchair user

More information