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 1 Address 2 Contoured seat w/ foam insert Flip away hip pads 4 point hip belt Angle adjustable footplate Height adjustable back Adjustable lumbar pad Hi-low Y base 4 locking casters City State Zip Phone Specifications Age Range (approx) Max User Weight Back Angle Back Pad Height (seat to top min/max) Back Pad Height w/ Extension Post Chest Width (min / max) Hip Width (min / max) Seat Depth (min / max) Lower Leg Length (min / max w/ 3 options) Seat Tilt (posterior / anterior) Seat to Floor (min / max) Y Base (Footprint) 18 mos - 5 yrs 3-8 yrs 5-12 yrs 110 lbs 110 lbs 110 lbs +15 to -15 +15 to -15 +15 to -15 12 1/4 to 16 1/4 13" to 17" 14 1/4 to 18 12 1/4 to 19 7 1/4 to 11 6 3/4 to 13 8 1/4 to 12 7 1/2 to 10 1/2 30 to -10 12 to 30 25 1/2 to 30 3/4 13" to 19 3/4" 7 1/4" to 11" 6 3/4" to 13" 9 1/2" to 12 1/2" 9 3/4" to 14 1/4" 30 to -10 13 1/4" to 30" 25 1/2" to 30 3/4" 14 1/4 to 21 7 1/4 to 11 6 3/4 to 13 10 3/4 to 15 1/4 9 3/4 to 16 30 to -10 13 1/4 to 30 25 1/2 to 30 3/4
Jenx HCPCS E1399 seat includes contoured polyurethane seat with removable abduction pad and memory foam seat insert. Adjustable flip away hip pads, angle adj. flip up footplate, 4 point hip belt, height adjustable back, independently adj. lumbar / sacral pad. Hi-Low Y-base with 4 locking casters. Seat and back cover in choice of color. $4,832 $4,842 $4,899 Standard Items Seat Cover One Seat Cover included with base purchase. & 3 seats use the same size cover. Back Cover One Back Cover included with base purchase. The back (and cover) is one size for all three models. The cover includes a pocket that an optional memory foam pad (JM15) can be inserted for comfort or skin protection. Blue COV010005 COV010006 COV010006 Pink COV020005 COV020006 COV020006 Lime COV030005 COV030006 COV030006 Red COV040005 COV040006 COV040006 Tan COV050005 COV050006 COV050006 Blue COV01 601 COV01 601 COV01 601 Pink COV02 601 COV02 601 COV02 601 Lime COV03 601 COV03 601 COV03 601 Red COV04 601 COV04 601 COV04 601 Tan COV05 601 COV05 601 COV05 601 Back Options Memory Foam Insert for Standard Back JM15 $87 JM15 $87 JM15 $87 Optional Medium Size Back The Medium (JB17) back pad replaces standard back for larger children who fit the length of traditional but need extra width for comfort and support. Fits JU15/16/17. Includes cover. Back Extension Post Adds extra height to either standard or medium back. JB17 $530 JB17 $530 JB17 $530 Blue COV01058 COV01058 COV01058 Pink COV02058 COV02058 COV02058 Lime COV03058 COV03058 COV03058 Red COV04058 COV04058 COV04058 Tan COV05058 COV05058 COV05058 JB18 $87 JB18 $87 JB18 $87 Push Handle Fixed JB03 $119 JB03 $119 JB03 $119 Optional Covers for Standard Items Hip Guide Covers Black polyurethane hip pads are standard, the covers listed here are optional. Angle Adj. JB07 $184 JB07 $184 JB07 $184 Blue COV01008 $98 COV01008 $98 COV01008 $98 Pink COV02008 $98 COV02008 $98 COV02008 $98 Lime COV03008 $98 COV03008 $98 COV03008 $98 Red COV04008 $98 COV04008 $98 COV04008 $98 Tan COV05008 $98 COV05008 $98 COV05008 $98 Optional Additional Hygiene Seat Cover (Black) JU72 $105 JU74 $116 JU74 $116 Continued on next page Page 2
Trunk Positioning, Short, No Strap (Pair) JB10 $295 JB10 $295 JB10 $295 Blue COV01027 $65 COV01027 $65 COV01027 $65 Pink COV02027 $65 COV02027 $65 COV02027 $65 Optional Covers Lime COV03027 $65 COV03027 $65 COV03027 $65, Long, With Strap (Pair) Red COV04027 $65 COV04027 $65 COV04027 $65 Tan COV05027 $65 COV05027 $65 COV05027 $65 JB12 $364 JB12 $364 JB12 $364 Blue COV01015 $65 COV01015 $65 COV01015 $65 Pink COV02015 $65 COV02015 $65 COV02015 $65 Optional Covers Lime COV03015 $65 COV03015 $65 COV03015 $65, Short, No Strap (Pair) Red COV04015 $65 COV04015 $65 COV04015 $65 Tan COV05015 $65 COV05015 $65 COV05015 $65 JB15 $317 JB15 $317 JB15 $317 Blue COV01063 $97 COV01063 $97 COV01063 $97 Pink COV02063 $97 COV02063 $97 COV02063 $97 Optional Covers Lime COV03063 $97 COV03063 $97 COV03063 $97, Long, With Strap (Pair) Red COV04063 $97 COV04063 $97 COV04063 $97 Tan COV05063 $97 COV05063 $97 COV05063 $97 JB16 $461 JB16 $461 JB16 $461 Blue COV01202 $97 COV01202 $97 COV01202 $97 Pink COV02202 $97 COV02202 $97 COV02202 $97 Optional Covers Lime COV03202 $97 COV03202 $97 COV03202 $97 Shoulder Protractors Pads on Swing Away Hardware (Pair) Red COV04202 $97 COV04202 $97 COV04202 $97 Tan COV05202 $97 COV05202 $97 COV05202 $97 MSB08 $396 MSB08 $396 MSB08 $396 Optional Black Cover JU82 $65 JU82 $65 JU82 $65 Page 3
Trunk Positioning (cont.) Zip Waistcoat Harness Available in 4 sizes. All sizes compatible with all seats however, the grid to the right displays the recommended sizes for each seat. Armrests Armrest Pair Trays and Tray Accessories HB01 $101 HB01 $101 HB02 $108 HB02 $108 HB02 $108 HB03 $112 HB03 $112 HB04 $133 JT01 $281 JT01 $281 JT01 $281 Tray for JT02 $350 JT03 $385 JT03 $385 Elbow Blocks for Tray JB08 $173 JB08 $173 JB08 $173 Grab Bar for Tray GT09 $122 GT09 $122 GT09 $122 Activity Frame for Tray GT10 $198 GT10 $198 GT10 $198 Half Tray Padding for JT02 GT15 $231 Half Tray Padding for JT03 GT16 $252 GT16 $252 Ful Tray Padding for JT02 GT18 $296 Full Tray Padding for JT03 GT19 $303 GT19 $303 Head Supports Blue MH02-01 $263 MH02-01 $263 MH02-01 $263 Pink MH02-02 $263 MH02-02 $263 MH02-02 $263 Oval Headrest Lime MH02-03 $263 MH02-03 $263 MH02-03 $263 Polyurethane pad with adjustable Red MH02-04 $263 MH02-04 $263 MH02-04 $263 mounting hardware. Tan MH02-05 $263 MH02-05 $263 MH02-05 $263 Black MH02-06 $263 MH02-06 $263 MH02-06 $263 Black Cover for Headrest Black JU69 $43 JU69 $43 JU69 $43 2 Link Multigrip Headrest MH01 01 $555 MH01 01 $555 MH01 01 $555 3 Link Multigrip Headrest MH05 $551 MH05 $551 MH05 $551 Stealth Headrest Interface Plate GB38 $418 GB38 $418 GB38 $418 Whitmeyer Headrest Interface Plate GB66 $101 GB66 $101 GB66 $101 Page 4
Leg and Pelvic Positioning Ischial Bar Simple yet effective positioning aid to resist sacral sitting. Position under memory foam in front of ischial tuberosities Seat Extension To be used on one side to accommodate leg length discrepancies. Not compatible with MSL08 Leg Control Brackets. Cover for Seat Extension JM11 $72 JM11 $72 JM11 $72 JL13 $108 JL13 $108 JL13 $108 JU71 $44 JU71 $44 JU71 $44 Hip Pad Extensions, Pair JL04 $226 JL04 $226 JL04 $226 Abduction Block Size 0 GL24 $108 GL24 $108 GL24 $108 Not compatible with GL08 Knee Blocks GL06 $170 GL06 $170 GL06 $170 GL07 $290 GL07 $290 GL07 $290 Knee Blocks Padded knee cups mounted from hip guides with swing away hardware. Providing anterior support and control to knees and legs. Leg Control Brackets Leg control pads control leg position independently of pelvic position, creating abduction, adduction or controlling windsweeping. Flip away for transfers. Use any combination of 1-4 pads (sold in pairs) GL08 $290 GL08 $290 GL08 $290 MSL08 $83 MSL08 $83 MSL08 $83 Leg Control Pad (Pair) MSL09 $386 MSL09 $386 MSL09 $386 Foot Positioning The comes with footplate JL06/JL09/JL10 depending on the size of chair purchased. Each footlate is also available as an accessory to retrofit should a different length be needed. 125mm Bracket Use with One Piece Footplate /. JL08 (125mm) is standard on the 9 3/4 to 16 seat to footplate range 65mm Bracket Use with One Piece Footplate / JL09 (65mm) is standard on the 9 3/4 to 14 1/4 seat to fooptlate range 30mm Bracket Use with One Piece Footplate / JL09 (30mm) is standard on the 7 1/2 to 10 1/2 seat to footplate range JL08 $249 JL08 $249 JL09 $249 JL09 $249 JL10 $299 JL10 $299 Box Style Footplate GL41 $458 GL41 $458 GL41 $458 Footplate Pad S7 $112 S7 $112 S7 $112 Page 5
Foot Positioning (cont.) Booties (Pair) S5 $262 S5 $262 S5 $262 Sandals (Pair) S16 $123 S16 $123 S16 $123 Sandal Raising Blocks Set of 4 Risers and screws of sequential length. One set is used to accommodate a leg length discrepancy. This set cannot be used to evenly raise two sandals. Two sets must be used raised two different sandals due to the fact that the screws are of different lengths. Select size the same as the sandal selected. S2 $142 S2 $142 S2 $142 S3 $152 S3 $152 S3 $152 SRB1 $91 SRB1 $91 SRB1 $91 SRB2 $106 SRB2 $106 SRB2 $106 SRB3 $119 SRB3 $119 SRB3 $119 Page 6