Traxx 3 & Atigra 2 Script Form

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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 Traxx 3 Atigra 2 Adjustable Seat Width from 410 to 510 Seat Depth Infinite Adjustment from 360 to 510 Detachable T-Armrests, Height and Depth Adjustable Adjustable Seat Tilt (0 to 9 ) & Backrest Recline (90 to 120 ) Swing-away and Detachable Legrests (Standard Footplate) Standard Curved Headrest VR2 60Ah Controller Independent Suspension System 6 or 10km/h 300W Motors with 50Ah Batteries Padded Lap Belt Measurement Guide A (back height) B (arm height) C (lower leg length) D (seat depth) E (chest width) F (seat width) G (height from seat to top of head) H (shoulder width) Page 1 of 5

Seat Dimension Seat Width and Depth Width Depth 360 (14 ) 385 (15 ) 410 (16 ) 435 (17 ) 460 (18 ) 385 (19 ) 510 (20 ) 305 (12") 330 (13") 360 (14") 385 (15") 410 (16") 435 (17") 460 (18") 485 (19") 510 (20") Seat-to-Floor Height seat height measured from floor to seat pan at 0 tilt Manual Adjustable Lift (75) Rear seat height enter a figure between 460 and 570 Front seat height enter a figure between 460 and 570 Backrest Angle Manual Adjustable Recline If selected, circle appropriate preset below 90 95 100 105 110 Power Tilt with COG Shift (0 to 50 ) Power Lift (300) and Tilt (0 to 45 ) Combined with initial height 480 to 590 115 120 Power Recliner with Shear Reduction (0 to 80 ) Seat and Backrest Cushion Seat Cushion sizes according to seat frame settings KISS Seat Cushion Lite (75) w/ Metal Seat Pan AC Mobility Padded Seat Bare Seat Frame Backrest Cushion sizes accordinwg to seat frame settings KISS Backrest Cushion Lite and Cushion Contour Without Backrest Cushion Backrest Plate only Without Backrest Cushion Backrest Canes only Page 2 of 5

Armrests & Armpads Armrests reclining armrest is recoended while Power Recline is ordered Detachable T-Armrests Height and Depth Adjustable Flip-back Armrest Height Adjustable Flip-back Reclining Armrest Height Adjustable recoended with power recline Armpad Ergo Armpad 300 Padded Armpad 350 Contour Armpad 370 Legrests - Left Hand Side Legrests - Right Hand Side Central Mounted Legrest Central Mounted Legrest Fixed Central Mounted Legrest (85 to 95 ) Swing-away Legrests Fixed Central Mounted Legrest (85 to 95 ) Swing-away Legrests 75 Swing in/swing out Legrest (320 to 460) 90 Straight Legrest (280 to 370) 75 Swing in/swing out Legrest (320 to 460) 90 Straight Legrest (280 to 370) Manual Elevating Legrest (10 to 90 ) Manual Elevating Legrest (10 to 90 ) Power Elevating Legrest (10 to 80 ) Stump Support Power Elevating Legrest (10 to 80 ) Stump Support Page 3 of 7 75 Swing-away Legrest 90 Straight Legrest Manual Elevating Legrest Power Elevating Legrest Page 3 of 5

vvv Footplate - Left Hand Side selected only on the swing-away legrests Footplate - Right Hand Side selected only on the swing-away legrests Flip-up Standard Footplate Flip-up Angle and Depth Adjustable Footplate Flip-up Standard Footplate Flip-up Angle and Depth Adjustable Footplate Seat Accessories Headrest One-piece Curved Headrest (250 x 120 ) One-piece Curved Headrest Sideways Adjustable (350 x 120 ) Without Headrest AC Mobility Padded Headrest Flip-back Tube Poel Poel, Small (80 x 80 ) Poel, Large (100 x 100 ) Removable and Drop-down Brackets Positioning Straps No Belt Padded Lap Belt Padded H-Belt Trunk Support - Left Hand Side Lateral Support, Short (120 x 80 ) Lateral Support, Medium (150 x 80 ) Lateral Support, Long (180 x 100 ) Lateral Support, Extra Long (210 x 100 ) Removable and Swing-away Brackets Trunk Support - Right Hand Side Lateral Support, Short (120 x 80 ) Lateral Support, Medium (150 x 80 ) Lateral Support, Long (180 x 100 ) Lateral Support, Extra Long (210 x 100 ) Removable and Swing-away Brackets With 3D Air Mesh Fabric Cover With 3D Air Mesh Fabric Cover Hip Support - Left Hand Side Hip Support - Right Hand Side Hip Support, Short (150 x 80 ) Hip Support, Long (250 x 100 ) Removable Brackets Swing-away Brackets Hip Support, Short (150 x 80 ) Hip Support, Long (250 x 100 ) Removable Brackets Swing-away Brackets Page 4 of 5

Power Base Colour Speed Limit Motor Metallic Red Kelvin Blue Silver Black 6 km/h 10 km/h 300W 2-Pole Motor * 2 only available for Atigra 2 450W 4-Pole Motor * 2 available for Atigra 2 and Traxx 3 Controller Controls VR2 Controller Joystick Controller Bracket - Left Hand Side Standard Bracket Parallel Swing away R-Net JSM Control System R-net System is required for over 2 actuators R-Net CJSM Control System with colour screen R-net System is required for over 2 actuators Joystick Controller Bracket - Right Hand Side Standard Bracket Parallel Swing away Joystick Knobs T Shaped Soft Ball Shaped L Shaped Mushroom Shaped Short Shaped Ball Shaped Battery Accessories Charger Without Batteries 50 AH * 2 6A Charger (100~220V) 8A Charger (100~220V) Light Lighting System with Indicators & LED Lighting Transportation Kit 4-Point tie-down Accessories Lap Trap Cane Holder IV Pole Holder Oxygen Tank Holder Cell Phone Holder Tablet Holder Page 5 of 5