Invacare Rehab Seating and Positioning Products

Size: px
Start display at page:

Download "Invacare Rehab Seating and Positioning Products"

Transcription

1 Price List and Order Form Effective Oct 13, 2008 rev. Dec. 1, 2009 For ease of ordering, contact Customer Service Toll Free at: Fax: To order Literature: Company Name Account # Phone P.O. # Date Ship to Name & Address ABSOLUTE CUSHIONS Absolute Cushion Single Density Cushion Comfort Mate Extra Cushion INFINITY CUSHIONS Lo Contour ViscoFoam Lo Contour FloGel Lo Contour AirFlo Gentle Contour ViscoFoam Gentle Contour FloGel Gentle Contour AirFlo Max Contour ViscoFoam Max Contour FloGel Max Contour AirFlo INTOUCH CUSHIONS InTouch Flovair Gentle Contour InTouch Flovair Max Contour InTouch Stabilite Gentle Contour InTouch Stabilite Max Contour InTouch Stabilite OM ULTIMATE CUSHIONS Ulti-Mate Junior Cushion Ulti-Mate Adult Cushion Ulti-Mate Junior Base Cushion Ulti-Mate Adult Base Cushion BACKS InTouch Propel Back Curved Back Curved Back Pneumatic Infinity Backs Personal Back10 InTouch PCS ACCESSORIES Cushion Rigidizer Drop Base Headrest Systems Adductors Abductors Universal Headrest Adapter Plate Shoulder Supports Lap Belts Full Tray Hook and Loop Mount Full Trays Slide-On Half Lap Trays Swingaway Wheelchair Tray Accessories Cushion Repair Kit KSS SEATING SYSTEM KSS Kinesthetic Seating System KSS Deluxe Seating System PAGE 2 PAGE 3 PAGE 5 PAGE 7 PAGE 8 PAGE 10 PAGE 11 For the most current pricing information go to Page 1

2 ABSOLUTE CUSHION General Purpose Cushion COMFORT-MATE EXTRA CUSHION Skin Protection Cushion EC Absolute Cushion (E2601)... $ EC66 Absolute Cushion 16x16 (E2601) EC68 Absolute Cushion 16x18 (E2601) EC86 Absolute Cushion 18x16 (E2601) EC88 Absolute Cushion 18x18 (E2601) EC06 Absolute Cushion 20x16 (E2601) EC08 Absolute Cushion 20x18 (E2601) CWC/(Size) Absolute Replacement Cover SINGLE DENSITY CUSHION General Purpose Cushion SD Single Density (E2601/E2602)... $ CWC/(Size) Single Density Replacement Cover SEAT WIDTH W10 10" Wide...No Charge W11 11" Wide...No Charge W12 12" Wide...No Charge W13 13" Wide...No Charge W14 14" Wide...No Charge W15 15" Wide...No Charge W16 16" Wide...No Charge W17 17" Wide...No Charge W18 18" Wide...No Charge W19 19" Wide...No Charge W20 20" Wide...No Charge W21 21" Wide...No Charge W22 22" Wide W23 23" Wide W24 24" Wide CMEX Comfort Mate Extra (E2603/E2604)... $ CMEX66 Comfort Mate Extra 16x16 (E2603) CMEX68 Comfort Mate Extra 16x18 (E2603) CMEX86 Comfort Mate Extra 18x16 (E2603) CMEX88 Comfort Mate Extra 18x18 (E2603) CMEX06 Comfort Mate Extra 20x16 (E2603) CMEX08 Comfort Mate Extra 20x18 (E2603) CMEXC/(Size) Comfort Mate Extra Outer Cover Absolute/Single Density Cushion Size Chart Depth (in) Width (in) 10 S S S S S S S S S S 11 S S S S S S S S S S 12 S S S S S S S S S S 13 S S S S S S 14 S S S S S S S S S 15 S S S S S S S S S 16 S S S S S S E S E S S 17 S S S S S S S 18 S S E S E S S 19 S S S S S 20 E S E S S 21 S S S S S 22 S S S S S 23 S S S S S 24 S S S S S E = Absolute S = Single Density Comfort-Mate Extra Cushion Size Chart Depth (in.) Width (in.) 14 C C C 15 C C C C C C 16 C S C S C S 17 C C C C C C 18 C S C S C S 19 C C C C C C 20 C C C C 21 C C C C 22 C C C C C = Configured (Builder) D7 D8 D9 D10 D11 D12 D13 D14 D15 D16 D17 D18 D19 D20 SEAT DEPTH 7" Deep...No Charge 8" Deep...No Charge 9" Deep...No Charge 10" Deep...No Charge 11" Deep...No Charge 12" Deep...No Charge 13" Deep...No Charge 14" Deep...No Charge 15" Deep...No Charge 16" Deep...No Charge 17" Deep...No Charge 18" Deep...No Charge 19" Deep...No Charge 20" Deep...No Charge For the most current pricing information go to Page 2

3 INFINITY LO CONTOUR VISCOFOAM Skin Protection Cushion Invacare Rehab Seating and Positioning Products Infinity Cushions INFINITY LO CONTOUR FLOGEL Skin Protection Cushion ILCVF Lo Contour Visco Foam (E2603/E2604) ILCVF66 Lo Contour Visco Foam 16 x16 (E2603) ILCVF68 Lo Contour Visco Foam 16x18 (E2603) ILCVF86 Lo Contour Visco Foam 18x16 (E2603) ILCVF88 Lo Contour Visco Foam 18 x18 (E2603) ILCVF06 Lo Contour Visco Foam 20x16 (E2603) ILCVF08 Lo Contour Visco Foam 20x18 (E2603) LCC/(size) Lo Contour Outer Cover INFINITY GENTLE CONTOUR VISCOFOAM Skin Protection and Positioning Cushion ILCFG Lo Contour FloGel (2603/E2604) ILCFG66 Lo Contour FloGel 16x16 (2603) ILCFG68 Lo Contour FloGel 16x18 (2603) ILCFG86 Lo Contour FloGel 18x16 (2603) ILCFG88 Lo Contour FloGel 18x18 (2603) ILCFG06 Lo Contour FloGel 20x16 (2603) ILCFG08 Lo Contour FloGel 20x18 (2603) LCC/(size) Lo Contour Outer Cover INFINITY GENTLE CONTOUR FLOGEL Skin Protection and Positioning Cushion IGCVF Gentle Visco Foam (E2607/E2608) IGCVF66 Gentle Visco Foam 16x16 (E2607) IGCVF68 Gentle Visco Foam 16x18 (E2607) IGCVF86 Gentle Visco Foam 18x16 (E2607) IGCVF88 Gentle Visco Foam 18x18 (E2607) IGCVF06 Gentle Visco Foam 20x16 (E2607) IGCVF08 Gentle Visco Foam 20x18 (E2607) GCC/(size) Gentle Contour Outer Cover INFINITY MAX CONTOUR VISCOFOAM Skin Protection and Positioning Cushion IGCFG Gentle Contour FloGel (E2607/2608) IGCFG66 Gentle Contour FloGel 16x16 (E2607) IGCFG68 Gentle Contour FloGel 16x18 (E2607) IGCFG86 Gentle Contour FloGel 18x16 (E2607) IGCFG88 Gentle Contour FloGel 18x18 (E2607) IGCFG06 Gentle Contour FloGel 20x16 (E2607) IGCFG08 Gentle Contour FloGel 20x18 (E2607) GCC/(size) Gentle Contour Outer Cover INFINITY MAX CONTOUR FLOGEL Skin Protection and Positioning Cushion IMCVF Max Contour Visco Foam (E2607/E2608) IMCVF66 Max Contour Visco Foam 16x16 (E2607) IMCVF68 Max Contour Visco Foam 16X18 (E2607) IMCVF88 Max Contour Visco Foam 18x18 (E2607) IMCVF06 Max Contour Visco Foam 20x16 (E2607) IMCVF08 Max Contour Visco Foam 20x18 (E2607) MCC/(size) Max Contour Outer Cover IMCFG Max Contour FloGel (E2607/2608) IMCFG66 Max Contour FloGel 16x16 (E2607) IMCFG68 Max Contour FloGel 16x18 (E2607) IMCFG86 Max Contour FloGel 18x16 (E2607) IMCFG88 Max Contour FloGel 18x18 (E2607) IMCFG06 Max Contour FloGel 20x16 (E2607) IMCFG08 Max Contour FloGel 20x18 (E2607) MCC/(size) Max Contour Outer Cover For the most current pricing information go to Page 3

4 Infinity Cushions INFINITY LO CONTOUR AIRFLO CONFIGURED/ BUILDER SIZES Adjustable, Skin Protection Cushion ILCAIR Lo Contour AirFlo (K0734/K0735) ILCAIR66 Lo Contour AirFlo 16x16 (K0734) ILCAIR68 Lo Contour AirFlo 16x18 (K0734) ILCAIR86 Lo Contour AirFlo 18x16 (K0734) ILCAIR88 Lo Contour AirFlo 18x18 (K0734) ILCAIR06 Lo Contour AirFlo 20x16 (K0734) ILCAIR08 Lo Contour AirFlo 20x18 (K0734) ALC/(size) Lo Contour Outer Cover INFINITY GENTLE CONTOUR AIRFLO Adjustable, Skin Protection and Positioning Cushion IGCAIR Gentle Contour AirFlo (K0736/K0737) IGCAIR66 Gentle Contour AirFlo 16x16 (K0736) IGCAIR68 Gentle Contour AirFlo 16x18 (K0736) SEAT WIDTH W13 13" Wide...No Charge W14 14" Wide...No Charge W15 15" Wide...No Charge W16 16" Wide...No Charge W17 17" Wide...No Charge W18 18" Wide...No Charge W19 19" Wide...No Charge W20 20" Wide...No Charge W21 21" Wide...No Charge W22 22" Wide D15 D16 D17 D18 D19 D20 SEAT DEPTH 15" Deep...No Charge 16" Deep...No Charge 17" Deep...No Charge 18" Deep...No Charge 19" Deep...No Charge 20" Deep...No Charge Infinity Cushions Size Chart Depth (in.) Width (in.) 13 C C C C 14 C C C C 15 C C C C C C 16 C S C S C S 17 C C C C C C 18 C S C S C S 19 C C C C C C 20 C C C C C C 21 C C C C C C 22 C C C C C C C = Configured (Builder) MODIFICATIONS IGCAIR86 Gentle Contour AirFlo 18x16 (K0736) IGCAIR88 Gentle Contour AirFlo 18x18 (K0736) RLW Removable 1" Leg Wedges IGCAIR06 Gentle Contour AirFlo 20x16 (K0736) LLD-L1 Leg Length Cut Out 1" User s Left IGCAIR08 Gentle Contour AirFlo 20x18 (K0736) LLD-R1 Leg Length Cut Out 1" User s Right AGC/(size) Gentle Contour Outer Cover LLD-L2 Leg Length Cut Out 2" User s Left LLD-R2 Leg Length Cut Out 2" User s Right INFINITY MAX CONTOUR AIRFLO Adjustable, Skin Protection and Positioning Cushion Modifications to cushions must be ordered with the cushion and cannot be ordered separately. IMCAIR Max Contour AirFlo (K0736/K0737) IMCAIR66 Max Contour AirFlo 16x16 (K0736) IMCAIR68 Max Contour AirFlo 16x18 (K0736) IMCAIR86 Max Contour AirFlo 18x16 (K0736) IMCAIR88 Max Contour AirFlo 18x18 (K0736) IMCAIR06 Max Contour AirFlo 20x16 (K0736) IMCAIR08 Max Contour AirFlo 20x18 (K0736) AMC/(size) Max Contour Outer Cover For the most current pricing information go to Page 4

5 InTouch Cushions INTOUCH FLOVAIR GENTLE CONTOUR 1 INTOUCH STABILITE GENTLE CONTOUR 1 Skin Protection and Positioning Couch Skin Protection and Positioning Cushion ITFG InTouch Flovair Gentle (E2607/2608) ITFG66 InTouch Flovair Gentle 16x16 (E2607) ITFG68 InTouch Flovair Gentle 16x18 (E2607) ITFG86 InTouch Flovair Gentle 18x16 (E2607) ITFG88 InTouch Flovair Gentle 18x18 (E2607) ITFG06 InTouch Flovair Gentle 20x16 (E2607) ITFG08 InTouch Flovair Gentle 20x18 (E2607) ITFGC/(size) InTouch Flovair Gentle Contour Outer Cover INTOUCH FLOVAIR MAX CONTOUR 1 Skin Protection and Positioning Cushion ITSG InTouch Stabilite Gentle (E2607/2608) ITSG66 InTouch Stabilite Gentle 16x16 (E2607) ITSG68 InTouch Stabilite Gentle 16x18 (E2607) ITSG86 InTouch Stabilite Gentle 18x16 (E2607) ITSG88 InTouch Stabilite Gentle 18x18 (E2607) ITSG06 InTouch Stabilite Gentle 20x16 (E2607) ITSG08 InTouch Stabilite Gentle 20x18 (E2607) ITSGC/(size) InTouch Stabilite Gentle Contour Outer Cover INTOUCH STABILITE MAX CONTOUR 1 Positioning Cushion ITFM InTouch Flovair Max (E2607) ITFM66 InTouch Flovair Max 16x16 (E2607) ITFM68 InTouch Flovair Max 16x18 (E2607) ITFM86 InTouch Flovair Max 18x16 (E2607) ITFM88 InTouch Flovair Max 18x18 (E2607) ITFM06 InTouch Flovair Max 20x16 (E2607) ITFM08 InTouch Flovair Max 20x18 (E2607) ITFMC/(size) InTouch Flovair Max Contour Outer Cover CONFIGURED/ BUILDER SIZES SEAT WIDTH W15 15" Wide...No Charge W16 16" Wide...No Charge W17 17" Wide...No Charge W18 18" Wide...No Charge W19 19" Wide...No Charge W20 20" Wide...No Charge W21 21" Wide...No Charge W22 22" Wide W23 23" Wide W24 24" Wide D15 D16 D17 D18 D19 D20 SEAT DEPTH 15" Deep...No Charge 16" Deep...No Charge 17" Deep...No Charge 18" Deep...No Charge 19" Deep...No Charge 20" Deep...No Charge ITSM InTouch Stabilite Max (E2605) ITSM66 InTouch Stabilite Max 16x16 (E2605) ITSM68 InTouch Stabilite Max 16x18 (E2605) ITSM86 InTouch Stabilite Max 18x16 (E2605) ITSM88 InTouch Stabilite Max 18x18 (E2605) ITSM06 InTouch Stabilite Max 20x16 (E2605) ITSM08 InTouch Stabilite Max 20x18 (E2605) ITSMC/(size) InTouch Stabilite Max Contour Outer Cover Gentle Cushion Size Chart Depth Width 15 C C C C C C 16 C S C S C S 17 C C C C C C 18 C S C S C S 19 C C C C C C 20 C S C S C C 21 C C C C C C C 22 C C C C C C C 23 C C C C C C C 24 C C C C C C C C = Configured (Builder) Max Cushion Size Chart Depth (in.) Width (in.) 15 C C C C C C 16 C S C S C S 17 C C C C C C 18 C S C S C S 19 C C C C C C 20 C S C S C C C = Configured (Builder) 1 Incontinence cover is standard. For the most current pricing information go to Page 5

6 InTouch Cushions INTOUCH STABILITE OM 2 CONFIGURED/BUILDER SIZES Positioning Cushion Bottom View ITSOM InTouch Stabilite OM (E2605/E2606) ITSOM66 InTouch Stabilite OM 16x16 (E2605) SEAT WIDTH 3 W14 14"Wide...No Charge 4 W15 15"Wide...No Charge W16 16"Wide...No Charge W17 17"Wide...No Charge W18 18"Wide...No Charge W19 19"Wide...No Charge W20 20"Wide...No Charge W21 21"Wide...No Charge W22 22"Wide W23 23"Wide W24 24"Wide SEAT DEPTH ITSOM68 InTouch Stabilite OM 16x18 (E2605) D15 15"Depth...No Charge ITSOM86 InTouch Stabilite OM 18 x16 (E2605) D16 16"Depth...No Charge ITSOM88 InTouch Stabilite OM 18x18 (E2605) D17 17"Depth...No Charge ITSOM06 InTouch Stabilite OM 20x16 (E2605) D18 18"Depth...No Charge ITSOM08 InTouch Stabilite OM 20x18 (E2605) D19 19"Depth...No Charge ITSOMC/(size)InTouch Stabilite OM Outer Cover D20 20"Depth...No Charge D21 21"Depth...No Charge INTOUCH STABILITE OM ACCESSORIES 2 D22 22"Depth...No Charge SOIPR/(Size) Additional Stabilite OM Obliquity Inserts (Pr) ITSTAB InTouch Stabilite OM Thin Air Bladder Stabilite OM Size Chart Depth (in.) Width (in) MODIFICATIONS RLW Removable 1" Leg Wedges LLD-L1 Leg Length Cut Out 1" User s Left LLD-R1 Leg Length Cut Out 1" User s Right LLD-L2 Leg Length Cut Out 2" User s Left LLD-R2 Leg Length Cut Out 2" User s Right Modifications to cushions must be ordered with the cushion and cannot be ordered separately. 14 C C C 15 C C C C C C 16 C S C S C S 17 C C C C C C 18 C S C S C S 19 C C C C C C 20 C S C S C C 21 C C C C C C C 22 C C C C C C C 23 C C C C C C C 24 C C C C C C C C= Configured (Builder) The Stabilite OM cushion was designed to address mild and moderate pelvic obliquities, now or in the future. Note: On all Stabilite OM cushions the actual depth dimensions will be slightly longer than the wheelchair dimensions due to the posterior pelvic lip which allows for good pelvic positioning. This extra depth does not affect the actual seating depth. Level Pelvis One half-inch adjustment One-inch adjustment 2 Incontinence cover is standard 3 Product weight capacity on Seat Width 15" 20" is 300 lbs; weight capacity on Seat Widths 21 " - 24 " is 500 lbs. 4 Stabilite OM Only 5 $ upcharge for widths 22, 23, 24. For the most current pricing information go to Page 6

7 Conventional Cushions ULTI-MATE CUSHION CONFIGURED/ BUILDER SIZES Positioning Cushion SEAT WIDTH UMJ Ulti-Mate Junior Cushion (E2605) UM Ulti-Mate Adult Cushion (E2605) UM66 Ulti-Mate Adult Cushion 16x16 (E2605) UM68 Ulti-Mate Adult Cushion 16x18 (E2605) UM86 Ulti-Mate Adult Cushion 18x16 (E2605) UM88 Ulti-Mate Adult Cushion 18x18 (E2605) UM06 Ulti-Mate Adult Cushion 20x16 (E2605) UM08 Ulti-Mate Adult Cushion 20x18 (E2605) UM/(sizeh) Builder sizes (Ulti-Mate Cushion Chart) (E2605) UMJOC/(size) Ulti-Mate Junior Cushion cover UMOC/(size) Ulti-Mate Adult Cushion Cover Builder sizes (Ulti-Mate Cushion chart) ULTI-MATE BASE CUSHION W10 W11 W12 W13 W14 W15 W16 W17 W18 W19 W20 W21 D10 D11 D12 D13 D14 D15 D16 D17 D18 D19 D20 10" Wide...No Charge 11" Wide...No Charge 12" Wide...No Charge 13" Wide...No Charge 14" Wide...No Charge 15" Wide...No Charge 16" Wide...No Charge 17" Wide...No Charge 18" Wide...No Charge 19" Wide...No Charge 20" Wide...No Charge 21" Wide...No Charge SEAT DEPTH 10" Deep...No Charge 11" Wide...No Charge 12" Wide...No Charge 13" Wide...No Charge 14" Wide...No Charge 15" Wide...No Charge 16" Deep...No Charge 17" Deep...No Charge 18" Deep...No Charge 19" Deep...No Charge 20" Deep...No Charge UMJB Ulti-Mate Junior Base Cushion UMB Ulti-Mate Adult Base Cushion UMB66 Ulti-Mate Base Cushion 16x UMB68 Ulti-Mate Base Cushion 16x UMB86 Ulti-Mate Base Cushion 18x UMB88 Ulti-Mate Base Cushion 18x UMB06 Ulti-Mate Base Cushion 20x UMB08 Ulti-Mate Base Cushion 20x UMB/(size) Builder sizes (Ulti-Mate Cushion Chart) (Includes: Cushion, Pan, and Fixed Height Drop Hooks) UJBOC/(size) Ulti-Mate Junior Base Outer Cover UMBOC/(size) Ulti-Mate Adult Base Outer Cover Builder sizes (Ulti-Mate Base Chart) Ulti-Mate Cushion, Base and Outer Covers Depth (in.) Width (in.) 10 B B B 11 B B B B 12 B B B B 13 B B B B 14 B B B S 15 B B B B B 16 B B S B S 17 B B B B B 18 B B S B S B B 19 B B B B B B B 20 B B S B S B B 21 B B B B B B B Note: The Ulti-Mate Cushion can be ordered in Bariatric/Heavy duty sizes. Contact Customer Service for pricing and availability. B = Builder (Configured) 5 Business Days Note: On all Ulti-Mate cushions and bases the actual depth dimensions will be slightly longer than the wheelchair dimensions due to the posterior pelvic lip which allows for good pelvic positioning. This extra depth does not affect the actual seating depth. Specify Drop Base Mount: Specify Patient Information: (0") Flush 1" Drop Patient Weight Under 250 lbs 2" Drop Patient Weight over 250 lbs 3" Drop Patient weight over 250 lbs must be Specify Drop Base Hook Size ordered as a Special 1" 7/8" ULTI-MATE MODIFICATIONS L1 Leg Length Cut Out Users Left 1" L2 Leg Length Cut Out Users Left 2" R1 Leg Length Cut Out Users Right 1" R2 Leg Length Cut Out Users Right 2" OBL5 Obliquity Build-up, Users Left ½" OBL1 Obliquity Build-up, Users Left 1" OBL15 Obliquity Build-up, Users Left 1 ½" OBR5 Obliquity Build-up, Users Right ½" OBR1 Obliquity Build-up, Users Right 1" OBR15 Obliquity Build-up, Users Right 1 ½" POKMD Pelvic Obliquity Kit 14" 16" Ulti-Mates POKLG Pelvic Obliquity Kit 17" 20" Ulti-Mates Upcharge added to builder cushion price and extends lead time to ten days For the most current pricing information go to Page 7

8 Backs CURVED BACK HEIGHT INTOUCH PROPEL BACK H10 General Use Back ITPR InTouch Propel Back (E2611) ITPR16 InTouch Propel Back 16" Wide (E2611) ITPR18 InTouch Propel Back 18" Wide (E2611) ITPR20 InTouch Propel Back 20" Wide (E2611) InTouch Propel Back Size Chart Height 17" Width 16" 17" R 18" 19" R 20" 21" R Propel Back Widths can be ordered as non-configured (16, 18, 20 ), or configured (17, 19, 21 ) CURVED BACK General Use Back H11 H12 H13 H14 H15 H16 H17 H18 H19 H20 10 High...No Charge 11 High...No Charge 12 High...No Charge 13 High...No Charge 14" High...No Charge 15" High...No Charge 16" High...No Charge 17" High...No Charge 18" High...No Charge 19" High...No Charge 20" High...No Charge Curved Back/Pneumatic Curved Back Height (in.) Width (in.) 10 B B B S B B B S B B B 15 B B B B 16 S B B B S 17 B B B B B 18 B B S B S 19 B B B B B 20 B B B B S 21 B B B B B 22 B B B B B B = Builder 5 Business Days INFINITY DUALFLEX BACK Positioning Back CBK Curved Back (E2611/E2612) CBK/(size) Builder sizes see chart (E2611/E2612) Specify Curve Back Mount: Specify Hook Size (0") Flush 1" 1" Recess 7/8" 2" Recess 3" Recess CURVED BACK PNEUMATIC CBKP Curved Back Pneumatic (E2611/E2612) CBKP/(size) Builder sizes see chart (E2611/E2612) CONFIGURED/ BUILDER SIZES CURVED BACK WIDTH W10 10 Wide...No Charge W11 11 Wide...No Charge W12 12 Wide...No Charge W13 13 Wide...No Charge W14 14" Wide...No Charge W15 15" Wide...No Charge W16 16" Wide...No Charge W17 17" Wide...No Charge W18 18" Wide...No Charge W19 19" Wide...No Charge W20 20" Wide...No Charge W21 21" Wide...No Charge W22 22" Wide IDSX DualFlex10 Short (14" Height) (E2615/2616) IDFX DualFlex10 Regular (16" Height) (E2615/2616) IDTX DualFlex10 Tall (19" Height) (E2615/2616) BACK CONTOUR ML Mild Contour...No Charge MX Max Contour MIX Mixed Contours ,7 BACK WIDTH SM Small (14" to 16" Wide)...No Charge MD Medium (17" to 19" Wide)...No Charge LR Large (20" to 22" Wide) Mixed Contour = Mild/Max Contour combinations. 7 Mixed contour Laterals and Pelvic Stabilizers are not available with LoBack. For the most current pricing information go to Page 8

9 Backs PERSONAL BACK10 ACCESSORIES/OPTIONS Positioning Back FP64A Foam In Place Chemical Kit VF Visco Foam INTOUCH PCS Positioning Back with Lateral Supports Personal Back10 Regular Personal Back10 Plus PBR Personal Back10 Regular (E2615/E2616) PBR16 Personal Back 10 16" Regular (E2615) PBR18 Personal Back10 18" Wide Reg (E2615) PBR20 Personal Back10 20" Reg (E2615) PBT Personal Back10 Tall (E2615/E2616) PBT16 Personal Back10 16" Tall (E2615) PBT18 Personal Back10 18" Wide Tall (E2615) PBT20 Personal Back10 20" Wide Tall (E2615) PPR Personal Back10 Plus Regular (E2615/E2616) PPR16 Personal Back10 16" Plus Reg (E2615) PPR18 Personal Back10 18" Plus Reg (E2615) PPR20 Personal Back 10 20" Plus Reg (E2615) PPT Personal Back10 Plus Tall (E2615/E2616) PPT16 Personal Back10 16" Plus Tall (E2615) PPT18 Personal Back10 18" Plus Tall (E2615) PPT20 Personal Back10 20" Plus Tall (E2615) PBRC/(size) Cover sizes Reg. Ht. see size chart PBTC/(size) Cover sizes Tall Ht. see size chart PPRC/(size) Cover sizes Plus Reg. Ht. see size chart PPTC/(size) Cover sizes Plus Tall Ht. see size chart CONFIGURED/BUILDER SIZES ITPCSR InTouch PCS Regular-16 High (E2620/E2621) ITPCSR16 InTouch PCS 16" Regular (E2620) ITPCSR18 InTouch PCS 18" Regular (E2620) ITPCSR20 InTouch PCS 20" Reg (E2620) ITPCST InTouch PCS Tall-20 High (E2620/ E2621) ITPCST16 InTouch PCS 16" Tall (E2620) ITPCST18 InTouch PCS 18" Tall (E2620) ITPCST20 InTouch PCS 20" Tall (E2620) PCSRC/(size) Cover sizes Reg. Ht. see size chart PCSTC/(size) Cover sizes Tall Ht. see size chart W14 W15 InTouch PCS Back Width 14"Wide...No Charge 15"Wide...No Charge PERSONAL BACK10 WIDTH W16 16"Wide...No Charge W13 13 Wide...No Charge W17 17"Wide...No Charge W14 14" Wide...No Charge W18 18"Wide...No Charge W15 15" Wide...No Charge W19 19"Wide...No Charge W16 16" Wide...No Charge W20 20"Wide...No Charge W17 17" Wide...No Charge W21 21"Wide...No Charge W18 18" Wide...No Charge W22 22"Wide (Bariatric) W19 19" Wide...No Charge W23 23"Wide (Bariatric) W20 20" Wide...No Charge W24 24"Wide (Bariatric) W22 22" Wide W24 24 Wide W26 26 Wide InTouch PCS Accessories / Options PCSTL Thoracic Lateral Supports, 4 (Pair) H14 H16 H19 PERSONAL BACK10 HEIGHT PCSPS Pelvic Stabilizer Supports, 3 (Pair) " High...No Charge 16" High...No Charge 19" High...No Charge Personal Back10 Size Chart Height (in.) Width (in.) 13 R - B T- B 14 R - B T - B 15 R - B T - 16 R T 17 R - B T - B 18 R T 19 R - B T - B 20 R T 22 8 R - B T - B 24 8 R - B T - B 26 8 R - B T - B R =Regular Height T = Tall Height B = Builder (5 Business Days) NOTE: The InTouch PCS back can be ordered for Invacare Power Wheelchairs with Power Recline. Must specify CG Recline Mounting Kit when ordering. The kit includes left and right mounting brackets, T-nuts, Hex nuts and MK6 Connector Tray. The kit is used in place of standard cane mounting hardware. Contact Customer Service for additional information. 8 Bariatric sizes include 22, 23, 24, and 26 widths at 500 lb. capacity. 9 VF option replaces standard HR foam in Personal Back10 backs with ViscoFoam For the most current pricing information go to Page 9

10 Seating and Positioning Accessories Cushion Rigidizers 10 Back Accessories (Sold Separately) CR Cushion Rigidizer CR66 Cushion Rigidizer for 16" x 16" CR68 Cushion Rigidizer for 16" x 18" CR86 Cushion Rigidizer for 18" x 16" CR88 Cushion Rigidizer for 18" x 18" CR06 Cushion Rigidizer for 20" x 16" CR08 Cushion Rigidizer for 20" x 18" Adductors 11 UNIVERSAL HEADREST ADAPTER PLATE 12 UHC Universal Headrest Clamp (E1028) WHC Whitmeyer Headrest Clamp (E1028) HEADREST SYSTEMS 12 BNSC Basic Headrest Child (E0955) BNSA Basic Headrest Adult (E0955) HR01S Small Adjustable. Headrest System (E0955) HR02S Large Adjustable. Headrest System (E0955) HR03S Two Step Adjustable. Headrest System (E0955) HR04S Curved Adjustable. Headrest System (E0955) Cushion Repair Kit ADDSM Adductor Small (E0956) ADDMD Adductor Medium (E0956) ADDLG Adductor Large (E0956) Special Builder sizes Flip Down Abductors 11 CRK Sealant for coated cushions (For use with Comfort-Mate Extra Cushion, Silhouette and Naked Contour U ) Lap Belts ABDLG Abductor Adult (E0957) ABDMD Abductor Child (E0957) Special Builder sizes Laterals for Curved Back 4PTLG 4 Point Hip Belt Adult PTMD 4 Point Hip Belt Junior PTSM 4 Point Hip Belt Child BPSLG Padded Lap Belt Adult side release BPSMD Padded Lap Belt Junior side release BPSSM Padded Lap Belt Child side release Special Builder Sizes LSFSM Fixed Lateral Support Small (E0956) LSFMD Fixed Lateral Support Medium (E0956) LSFLG Fixed Lateral Support Large (E0956) LSSSM Swingaway Lateral Support Small (E0956) LSSMD Swingaway Lateral Support Small (E0956) LSSLG Swingaway Lateral Support Small (E0956) Can be ordered as configured or non-configured 11 Intended for use with the Ulti-Mate base and Ulti-Mate Junior base cushions 12 UHC/WHC must be ordered if headrest will be mounted to an Infinity 10 Back. For the most current pricing information go to Page 10

11 BACKS Shoulder Supports Full Trays Slide-On 14 SSLG Adult (16" 20" Systems) (E0960) SSMD Junior (14" 16" Systems) (E0960) SSSM Child (10" 12" Systems) (E0960) Special Builder sizes LT02A/W12 Wheelchair Tray, Clear w/cutout (E0950) LT02A/W14 Wheelchair Tray, Clear w/cutout (E0950) LT02A/W16 Wheelchair Tray, Clear w/cutout (E0950) LT02A/W18 Wheelchair Tray, Clear w/cutout (E0950) LT04A/W12 Wheelchair Tray, Clear w/cutout (E0950) LT04A/W14 Wheelchair Tray, Clear w/cutout (E0950) Full Trays Hook and Loop Mount LT04A/W16 Wheelchair Tray, Clear w/cutout (E0950) LT04A/W18 Wheelchair Tray, Clear w/cutout (E0950) Half Lap Trays Swingaway LTACL Lap Tray, clear Adult (E0950) LTCCL Lap Tray, clear Child (E0950) LTACCL Communication Tray, clear Adult (E0950) LTCCCL Communication Tray, clear Child (E0950) Infinity Drop Bases 13 LTUL Swingaway Tray, clear left (E0950) LTUR Swingaway Tray, clear Right (E0950) Wheelchair Tray Accessories EPTL Elbow Pad for Tray users left EPTR Elbow Pad for Tray users right TR40L Tray support Arm Hardware left TR40R Tray support Arm Hardware right IDB Infinity Drop Base (K0108) IDBS16 14" to 16" wide x 16" deep (K0108) IDBS18 14" to 16" wide x 18" deep (K0108) IDBS20 14" to 16" wide x 20" deep (K0108) IDBM16 17" to 19" wide x 16" deep (K0108) IDBM18 17" to 19" wide x 18" deep (K0108) IDBM20 17" to 19" wide x 20" deep (K0108) IDBL16 20" to 22" wide x 16" deep (K0108) IDBL18 20" to 22" wide x 18" deep (K0108) IDBL20 20" to 22" wide x 20" deep (K0108) Can be ordered as configured or non-configured 14 Lap Trays are non-configured products. For the most current pricing information go to Page 11

12 KSS Seating System KSS Kinesthetic Seating System KSS10R *10" wide regular... 1, KSS11R *11" wide regular... 1, KSS12R *12" wide regular... 1, KSS13R *13" wide regular... 1, KSS14R *14" wide regular... 1, KSS15R *15" wide regular... 1, KSS16R *16" wide regular... 1, KSS18R *18" wide regular... 1, KSS20R *20" wide regular... 1, KSS14T 14" wide Tall... 1, KSS16T 16" wide Tall... 1, KSS17T 17" wide Tall... 1, KSS18T 18" wide Tall... 1, KSS19T 19" wide Tall... 1, KSS20T 20" wide Tall... 1, KSSBLDR Builder sizes see chart... 1, Deluxe KSS Kinesthetic Seating System DLX11R 11" wide Deluxe Regular... 1, DLX12R 12" wide Deluxe Regular... 1, DLX13R 13" wide Deluxe Regular... 1, DLX14R 14" wide Deluxe Regular... 1, DLX15R 15" wide Deluxe Regular... 1, DLX16R 16" wide Deluxe Regular... 1, DLX18R 18" wide Deluxe Regular... 1, DLX20R 20" wide Deluxe Regular... 1, DLX14T 14" wide Deluxe Tall... 1, DLX16T 16" wide Deluxe Tall... 1, DLX18T 18" wide Deluxe Tall... 1, DLX20T 20" wide Deluxe Tall... 1, DLXBLDR Builder sizes see chart... 1, Deluxe Seating System includes: Adjustable Headrest System, Swingaway Lateral Supports, Padded Lap Belt, Ulti-Mate Base, Curved Back and Hinged Growth Bracket for Pediatric systems. Complete KSS Worksheet for ordering detail. Growth Brackets GB *Growth Bracket...No Charge HGB Hinged Growth Bracket HGB includes adjustable angle hooks for back. Specify 7/8" or 1" diameter back canes. *GB or HGB must specify size of seating system when ordering as a part. *3" Growth adjustment provided by growth bracket on these models. Kinesthetic Seating System includes: Basic, Headrest, Basic Lateral Supports, Padded Lap Belt, Ulti-Mate Base, Curved Back and Growth Bracket for Pediatric systems. Complete KSS Worksheet for ordering details. Invacare Corporation USA One Invacare Way Elyria, OH USA All rights reserved. Trademarks are identified by the symbols and. All trademarks are owned by or licensed to Invacare Corporation unless otherwise noted. FloGel is a registered trademark of S.N.F. Specifications and prices are subject to change without notification Invacare Corporation Form No rev. '09

Invacare Rehab Seating and Positioning Products

Invacare Rehab Seating and Positioning Products Price List and Order Form Effective Oct 13, 2008 For ease of ordering, contact Customer Service Toll Free at: 800-333-6900 Fax: 800-678-4682 To order Literature: 800-828-6282 www.invacare.com Company Name

More information

Invacare Rehab Seating and Positioning Products

Invacare Rehab Seating and Positioning Products Price List and Order Form Effective Oct 13, 2008 (rev. 09/08/09) For ease of ordering, contact Customer Service Toll Free at: 800-333-6900 Fax: 800-678-4682 To order Literature: 800-828-6282 www.invacare.com

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

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

Invacare Respiratory Products. Invacare Aerosol IRC Invacare Select Compressor. IRC Invacare Pediatric Bear Nebulizer

Invacare Respiratory Products. Invacare Aerosol IRC Invacare Select Compressor. IRC Invacare Pediatric Bear Nebulizer This Month's Featured Respiratory Product Invacare Pediatric Bear Nebulizer Offers performance, reliability and value that providers and patients expect from Invacare. Includes mouthpiece and pediatric

More information

Invacare A4 Ultralight Active Performance Rigid

Invacare A4 Ultralight Active Performance Rigid Invacare A4 Ultralight Active Performance Rigid Price List and Order Form Effective January 15, 2008 Revised April 9, 2008 For ease of ordering, contact customer Service Toll Free at: 800-333-6900 Fax:

More information

Invacare A4 Titanium Ultralightweight Active Performance Rigid

Invacare A4 Titanium Ultralightweight Active Performance Rigid Price List and Order Form For ease of ordering, contact Customer Service Toll Free at: 800-333-6900 Fax: 800-678-4682 To order Literature: 800-828-6282 Effective July 1, 2008 rev September 22, 2009 www.invacare.com

More information

User Manual. Invacare Matrx Flovair. Models ITFM and ITFG. 1 General

User Manual. Invacare Matrx Flovair. Models ITFM and ITFG. 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. 1 General Invacare Matrx Flovair Models ITFM and

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

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. 1 General 1.1 Symbols Invacare Matrx Stabilite

More information

Invacare A4 Ultralight Active Performance Rigid

Invacare A4 Ultralight Active Performance Rigid Invacare A4 Ultralight Active Performance Rigid Price List and Order Form Effective January 15, 2008 Revised September 22, 2009 For ease of ordering, contact customer Service Toll Free at: 800-333-6900

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

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

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

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

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

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

Personal Care List Price List Ambulatory Bath Safety Commodes

Personal Care List Price List Ambulatory Bath Safety Commodes Price List and Order Form Effective July 1, 2009 For ease of ordering, contact Customer Service Toll Free at: 800-333-6900 Fax: 800-678-4682 To order Literature: 800-828-6282 www.invacare.com Company Name

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

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 ProSpin X4 Ultralightweight Active Performance Folder

Invacare ProSpin X4 Ultralightweight Active Performance Folder Invacare ProSpin X4 Ultralightweight Active Performance Folder Price List and Order Form Effective January 15, 2008 Revised December 1, 2009 For ease of ordering, contact customer Service Toll Free at:

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

SHIPPING INFORMATION Provider Acct #:

SHIPPING INFORMATION Provider Acct #: May 2014 Kid's ROCK TM Size 3 Order Form Maximum Weight Capacity 215 lbs. 17Wx20Dx26H Seating Capacity Customer Service: 800-800-8586 (toll free) Email: orders@pridemobility.com Date: Quote Order SHIPPING

More information

SHIPPING INFORMATION Provider Acct #:

SHIPPING INFORMATION Provider Acct #: May 2014 Kids ROCK TM Size 2 Order Form Maximum Weight Capacity 115 lbs. 14"Wx16"Dx22"H Seating Capacity. Customer Service: 800-800-8586 (toll free) Email: orders@pridemobility.com Date: Quote Order SHIPPING

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 Q6400Z Series Group 4 Order Form 300 lbs. weight capacity Quantum Rehab A Division of Pride Mobility Products Corporation 182 Susquehanna Ave., Exeter, PA 18643 Phone: (866)800-2002 Fax: (866)

More information

FDX (Formula CGE option included) and Front Riggings

FDX (Formula CGE option included) and Front Riggings Parts Catalog Issued: Jul 16, 2018 FDX (Formula CGE option included) and Front Riggings Power Wheelchair Parts Catalog Usage Guide The information contained in this document is subject to change without

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

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

$ $ $450 00

$ $ $450 00 MONTHLY PROMOTIONS NEW ARRIVALS! ASK FOR Promo Code: PROMONEWSEPT12 Onyx II Vantage Fingertip Oximeter nvision Data Management Software The Onyx II Vantage professional fingertip oximeter Powerful, easy-to-use

More information

Formula CG Tilt (CGT) Powered Seating

Formula CG Tilt (CGT) Powered Seating Parts Catalog Issued: Mar 12, 2018 Formula CG Tilt (CGT) Powered Seating TDX SC2-CG w/ TDX SC & TDX SPREE-CG w/ TDX SPREE Parts Catalog Usage Guide The information contained in this document is subject

More information

Chair Back Solid. Chair Back. Chair Back. Chair Back

Chair Back Solid. Chair Back. Chair Back. Chair Back Seats and Backs Seats and Backs Solid Up to 14 x 14... 0625 Up to 18 x 18... 062501 Up to 22 x 22... 062502 I-Modification Up to 14 x 14... 06258 Up to 18 x 18... 062510 Up to 22 x 22... 062511 T-Modification

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

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

Invacare Spree XT Wheelchair

Invacare Spree XT Wheelchair Invacare Spree XT Wheelchair Spree embodies the essence of the child in all of us. We all love to laugh, explore the world and meet new people. The Spree series of wheelchairs can help. They make life

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

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

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

Parts Catalog Issued: Jan 17, Bed Rails

Parts Catalog Issued: Jan 17, Bed Rails Parts Catalog Issued: Jan 17, 2017 Bed Rails Parts Catalog Usage Guide The information contained in this document is subject to change without notice. This catalog contains service parts for. If you have

More information

$ $ QUESTIONS? PLEASE CONTACT CUSTOMER SERVICE FOR ASSISTANCE

$ $ QUESTIONS? PLEASE CONTACT CUSTOMER SERVICE FOR ASSISTANCE ADJUSTER LOW & ADJUSTER DER FM HCPCS CODING: E2622/E2623 - ADJUSTABLE SKIN PROTECTION Adjuster Low Adjuster Company Name/ACCT #: P.O. Number: Requested By: Phone: Email: Ship To: Patient Reference: Fax:

More information

SEATING SERIES INVACARE MATRX

SEATING SERIES INVACARE MATRX SETING SERIES INVCRE MTRX SETING SERIES Molly (pictured above), was injured in 009 and is a single mother of two young, active boys. She works part-time as an estimator at a high-end construction company

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

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

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

Vector COMFORT-TEK FOR FLUID PROTECTION & AN EASILY CLEANED SURFACE. $ $455.00

Vector COMFORT-TEK FOR FLUID PROTECTION & AN EASILY CLEANED SURFACE. $ $455.00 VECT LOW & VECT DER FM HCPCS CODING: E2624/E2625 ADJUSTABLE SKIN PROTECTION & POSITIONING Vector Low Vector Company Name/ACCT #: P.O. Number: Requested By: Phone: Email: Ship To: Patient Reference: Fax:

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 6400Z Series Group 4 Single Power & Multiple Power Order Form 300 lbs. weight capacity Quantum Rehab A Division of Pride Mobility Products Corporation 182 Susquehanna Ave., Exeter, PA 18643 Phone:

More information

INVACARE Compass Series Positioning Wheelchairs

INVACARE Compass Series Positioning Wheelchairs INVACARE Compass Series Positioning Wheelchairs INVACARE Compass Series Complex Positioning And Seating Situations Compass series adult positioning wheelchairs The Invacare Compass Series adult manual

More information

R82 Wombat Living. CAD Retail Price List/ Order Form. Account #: Purchase Order No.: Date: Wombat Living Standard Features:

R82 Wombat Living. CAD Retail Price List/ Order Form. Account #: Purchase Order No.: Date: Wombat Living Standard Features: Account #: Purchase Order No.: Date: Contact: R82 Wombat Living CAD Retail Price List/ Order Form Mark For: Bill To: Address: City/State/Zip: Phone: Email Ship To: Address: City/State/Zip: Phone: Wombat

More information

SHIPPING INFORMATION. Order

SHIPPING INFORMATION. Order Size 3 Order Form MASS 2014 Maximum Weight Capacity 215 lbs. 17Wx20Dx26H Seating Capacity Pride Mobility Products Aust Pty Ltd 20-24 Apollo Drive Hallam VIC 3803 Ph: 03 8770 9600 Fax: 03 9703 2960 Date:

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

Parts Catalog Issued: Feb 5, Invacare I-Lift. Patient Transport Lift

Parts Catalog Issued: Feb 5, Invacare I-Lift. Patient Transport Lift Parts Catalog Issued: Feb 5, 2016 Invacare I-Lift Patient Transport Lift Parts Catalog Usage Guide The information contained in this document is subject to change without notice. This catalog contains

More information

SHIPPING INFORMATION Provider Acct #: Address: ST: ZIP:

SHIPPING INFORMATION Provider Acct #: Address: ST: ZIP: May 2014 Kids FAST Order Form Maximum Weight Capacity 80 lbs. 12"Wx14.5"Dx19.5"H Seating Capacity. Customer Service: 800-800-8586 (toll free) Email: orders@pridemobility.com Date: Quote Order SHIPPING

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

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

INVACARE CANADA AQUATEC Shower Commodes

INVACARE CANADA AQUATEC Shower Commodes INVACARE CANADA AQUATEC Shower Commodes Aquatec Shower Commodes Aquatec Shower Commodes offer superior functionality, maximum adjustability and an enhanced quality of life. Aquatec commodes feature an

More information

Ride JAVA Adjustable Back Support Owner s Handbook

Ride JAVA Adjustable Back Support Owner s Handbook Ride JAVA Adjustable Back Support Owner s Handbook Warranty Policy Installation and Use Instructions Warranty Policy Your Ride Designs JAVA Adjustable Back Support has been carefully constructed to meet

More information

[ ] Quote [ ] Order. Junior US Retail Price List. Account Information. Ship To Information. Standard Features.

[ ] Quote [ ] Order. Junior US Retail Price List. Account Information. Ship To Information. Standard Features. Account Information Date Account Number Branch Dealer Contact Phone Fax Email Address PO Number Mark For Ship To Information [ ] Quote [ ] Order Shown with Optional Equipment Standard Features Name Address

More information

Parts Catalog Issued: Mar 12, Comet Rocket. Wheelchairs

Parts Catalog Issued: Mar 12, Comet Rocket. Wheelchairs Parts Catalog Issued: Mar 2, 208 Comet Rocket Wheelchairs Parts Catalog Usage Guide The information contained in this document is subject to change without notice. This catalog contains service parts 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

Parts Catalog Issued: Mar 26, Xterra GT. Power Wheelchair

Parts Catalog Issued: Mar 26, Xterra GT. Power Wheelchair Parts Catalog Issued: Mar 26, 2018 Xterra GT Power Wheelchair Parts Catalog Usage Guide The information contained in this document is subject to change without notice. This catalog contains service parts

More information

Built by Invacare Designed by You.

Built by Invacare Designed by You. Built by Invacare Designed by You. Tradition. Innovation. Vision. For the last two and a half decades, Invacare has been the industry leader in powerchair electronics and bases. Every year, our engineers

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

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

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

W H E E L C H A I R S

W H E E L C H A I R S WHEELCHAIRS Value: Graham-Field is known for a broad product offering at affordable pricing, without sacrifice to quality. Like you, we understand that the cost of a product is more than a price tag. The

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

Bio-ST ST & ST-HD. Modifications Removable and/or Additional Foam Shape Contour Covers A A A A & A

Bio-ST ST & ST-HD. Modifications Removable and/or Additional Foam Shape Contour Covers A A A A & A Information is provided to: Quote Up-Date a Quote Q Order Quote # Q Purchase Order # Ordered By: Client s Name (Last, First):, Sales Person (RTS): Phone: Fax: E-Mail: Inside Contact: Phone: Fax: E-Mail:

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

Tilt in space up to 60 degrees Comfort seating Max. user weight: 113kg. Height adjustable folding back Heavy Duty version 158kg

Tilt in space up to 60 degrees Comfort seating Max. user weight: 113kg. Height adjustable folding back Heavy Duty version 158kg QUICKIE IRIS Invoice to: Deliver to: Name: Name: Street: Street: Town: Postal code: Town: E-Mail: E-Mail: Tel: Fax: Tel: Order date: Marked for: Purchase order: Number required: Sunrise order no: Base

More information

MEDIchair Northern BC nd Avenue Prince George, British Columbia V2L 3A6 Toll Free

MEDIchair Northern BC nd Avenue Prince George, British Columbia V2L 3A6 Toll Free MEDIchair Northern BC 849 2 nd Avenue Prince George, British Columbia V2L 3A6 Toll Free 1-800-330-2772 BC Ministry of Health A Cheat Sheet for Clinicians Included Features for a Basic Wheelchair, Basic

More information

Company Name Account # Phone # P.O.# Date FRAME SELECTIONS DEPTH

Company Name Account # Phone # P.O.# Date FRAME SELECTIONS DEPTH WIDTH Price List and Order Form Effective July 1, 200 Revised September 11, 2006 For ease of ordering, contact Customer Service Toll Free at: 800--6900 Fax: 800-678-4682 To order Literature: 800-828-6282

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

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

Manufacturer: Model: Seat width: cm Seat depth: cm

Manufacturer: Model: Seat width: cm Seat depth: cm Thompson House Unit 10, Styles Close, Sittingbourne, Kent ME10 3BF Tel: 01795 477280 Fax: 01795 229692 Email: sales@rms-kent.co.uk web: www.ineedawheelchair.co.uk Caddy modular seating system order form

More information

Storm Series 3G (Elevating Seat included ESS6-STM)

Storm Series 3G (Elevating Seat included ESS6-STM) Parts Catalog Issued: Oct 3, 2018 Storm Series 3G (Elevating Seat included ESS6-STM) Arrow Ranger X Torque SP/SE/3 Power Wheelchairs Parts Catalog Usage Guide The information contained in this document

More information

VERSATILE durable. soft to the touch. 3-year Manufacturer s Warranty

VERSATILE durable. soft to the touch. 3-year Manufacturer s Warranty VERSATILE durable adjustable SUPPORT soft to the touch 3-year Manufacturer s Warranty Regular Head Lateral Head Proper Made Easy Multi-Positioning Seat To securely hold your child in place with the proper

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

2004 Medicare Billing Guidelines for Rehab Products

2004 Medicare Billing Guidelines for Rehab Products 2004 Medicare Billing Guidelines for Rehab Products This document provides correct coding guidelines in a descriptive format comparable to the appendix found in the Medicare guidelines for wheelchair options/accessories.

More information

The order form has (MSRP) retail prices, but your price is at least 25% less than retail price. Multiply retail by.75 or call or for a quote.

The order form has (MSRP) retail prices, but your price is at least 25% less than retail price. Multiply retail by.75 or call or  for a quote. The order form has (MSRP) retail prices, but your price is at least 25% less than retail price. Multiply retail by.75 or call or email for a quote. The order form has (MSRP) retail prices, but your price

More information

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

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

More information

ORDER FORM EIPW25. with CAPTAIN'S SEAT. Print pages 1-10 to exclude pictures. Buyer State Zip

ORDER FORM EIPW25. with CAPTAIN'S SEAT. Print pages 1-10 to exclude pictures. Buyer State Zip ORDER FORM Print pages 1-10 to exclude pictures. with CAPTAIN'S SEAT EIPW25 Customer Account # Date PO# Ship To Name Address City Buyer State Zip Mark For Phone Client Measurements a) Top of head to seat

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

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

Parts Catalog Issued: Nov 10, 2006

Parts Catalog Issued: Nov 10, 2006 Parts Catalog Issued: Nov 10, 2006 MX Yes, you can. Parts Catalog Usage Guide The information contained in this document is subject to change without notice. This catalog contains service parts for. If

More information

SAVE THESE INSTRUCTIONS DANGER

SAVE THESE INSTRUCTIONS DANGER Contoura Back and Seat Cushions Assembly, Installation and Operating Instructions SAVE THESE INSTRUCTIONS To ensure the safe operation and use of the Contoura Back and Cushion, these instructions MUST

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

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

Personal Care Commode

Personal Care Commode Parts Catalog Issued: Jan 23, 2004 Personal Care Commode Yes, you can. PARTS CATALOG USAGE GUIDE The information contained in this document is subject to change without notice. This catalog contains service

More information

Personal Care Commode

Personal Care Commode Parts Catalog Issued: Jun 2, 2009 Personal Care Commode Yes, you can. Parts Catalog Usage Guide The information contained in this document is subject to change without notice. This catalog contains service

More information

A 1.- Bio ST Seats & Backs

A 1.- Bio ST Seats & Backs A 1.- Bio ST Seats & Backs The Bio ST seats and backs have been designed with the highest level of functionality while equally considering the need for durability. Every seat and back is constructed from

More information

Table of Contents. Order By: Trays. Positioning Straps. Seats and Backs. Bracket Hardware. Electronics. Seating Accessories. Order Forms.

Table of Contents. Order By: Trays. Positioning Straps. Seats and Backs. Bracket Hardware. Electronics. Seating Accessories. Order Forms. Products Catalog 2012 Table of Contents Richardson Products manufactures and distributes a broad spectrum of rehab and home medical equipment. Our products are manufactured using the highest quality materials

More information

Invacare Solara 3G Adult Tilt-in-Space Wheelchair

Invacare Solara 3G Adult Tilt-in-Space Wheelchair Invacare Solara 3G Adult Tilt-in-Space Wheelchair Price List and Order Form Effective July 13, 2009 For ease of ordering, contact customer Service Toll Free at: 800-333-6900 Fax: 800-678-4682 To order

More information

Formula Invisible Super Low Tilt

Formula Invisible Super Low Tilt Parts Catalog Issued: Aug 27, 2018 Formula Invisible Super Low Tilt For Storm Series TDX Power Wheelchairs Parts Catalog Usage Guide The information contained in this document is subject to change without

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

Velocity Order Form. Dealer Information Dealer Name ATP Account Number Phone Fax Date PO# Ship to Address City State Zip

Velocity Order Form. Dealer Information Dealer Name ATP Account Number Phone Fax  Date PO# Ship to Address City State Zip 1-800-963-7487 Fax: 239-772-3252 Velocity Order Form Dealer Information Dealer Name ATP Account Number Phone Fax E-Mail Date PO# Ship to Address City State Zip Client Information Weight Height Seat-to-Floor

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

Advancement Chair. R901, R902, & R903 Product Manual

Advancement Chair. R901, R902, & R903 Product Manual Advancement Chair R901, R902, & R903 Product Manual Contents Warnings and Important Information 3 Recommended Use 4 User and Item Dimensions 4 Assembly and Adjustment Information 5 Maintenance 14 Cleaning

More information

Model # Description 1037 Aluminum Rollator - Flame Red 1037BL Aluminum Rollator - Flame Blue 1037BK Aluminum Rollator - Flame Silver

Model # Description 1037 Aluminum Rollator - Flame Red 1037BL Aluminum Rollator - Flame Blue 1037BK Aluminum Rollator - Flame Silver ProBasics ProBasics Rollators A A. ProBasics Flame Finish Aluminum Rollator with Loop Brakes Featuring a lightweight, aluminum welded frame, full swivel front casters and easy squeeze brakes for progressive

More information

Invacare Compass Series Custom Manual Positioning Wheelchairs. Solara 2G Compass SPT Compass XE

Invacare Compass Series Custom Manual Positioning Wheelchairs. Solara 2G Compass SPT Compass XE Invacare Compass Series Custom Manual Positioning Wheelchairs Solara 2G Compass SPT Compass XE Invacare Compass Series Custom Manual Positioning Wheelchairs Compass - Complex Positioning And Seating Situations

More information

Owner s Handbook: Ride Java Back Support

Owner s Handbook: Ride Java Back Support ENGLISH Y i Owner s Handbook: Ride Java Back Support M Ride Designs a branch of Aspen Seating, LLC 8100 SouthPark Way, C400 Littleton, Colorado 80120 USA toll-free (U.S. Only): 866.781.1633 phone: 303.781.1633

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