SUBMITTING FOR: o Quote o Order
ST: ZIP:
( ) Fax: ( )
ST: ZIP:
o Fax o Email ( ) Fax: ( )
a a
*HCPCS Codes shown as submitted. Some sizes fit other HCPC codes i.e. 15-18 " widths = E1161 o o o o o o o o o o o o o o o o o o o
Maximum weight capacity for Z-Finity footrests is 165 lbs
$295.00 o
188GY02 188FT46
Width Adjusting system(built in growth 2") NA w/ Mono Back or Folding
o 188FS29
Fixed Struts(Growth thru kits) NA W/Folding STD
Frame Options o
Contracture Seat Frame(Not Avail. w/10" Frame Depth or Folding Frame) Battery Tray(Not avail. w/ 10" & 11" frame
widths, foot wheel lock or Folding)
NC 188W9
$45.00
NC o 188WM90 E1234 Zippie IRIS Folding Transit Optional
Includes True fit Growth. NA with Mono
$2,790.00 E1234 Zippie IRIS Folding Transit Included $2,940.00
Includes True fit Growth. NA w/Mono
STD NC
+5° to 60°
Pre-Set Tilt Angle (55° range) (Default in Bold, NA w/ reclining back)
STD NC 188TT12 NC o 188W8 188W2 11" (NA w/Mono) 188W6 188W3 188W4 14" Date: Dealer Acct #: Ship To: 188W1 o
Frame Struts (Rigid Frames Only) 188GY01
Frame Width (Custom set-up on 17" & 18" folding frame thru B4Me)
PO#: Address: 188W5 2. SIZE / SEATING 188TA5 Address: NC NC NC NC 17"(Folding Grows to 18" B4Me custom set-up)
NC 15" 16"(Folding Grows to 18") 13" 188TA7 188TA10 11-1/4" - 15-1/4" NC 188ST54 STD 15" - 19" 10" - 16" 14" - 18" NC 10" (NA w/ Mono) 12"
Omit Seat Pan
Dim A Range 188JC20 REFERENCE ONLY Width: o Ship To City:
-5° to 50° (Not available. with 12.5" STFH.)
Dual Trigger Cable Release
0° to 55°
STD
Name / Part #
To order any JAY cushions on-chair, please see the JAY price list. Cushion name or part number must be filled out with desired width and depth.
NC Dealer Phone: Confirm Via: Price o o 188WM91 Mark For: E1233 Ship To Phone: HCPCS Definition
The HCPCS CODES provided are based on code verification through PDAC or our interpretation of the code definitions. The use of HCPCS CODES does not ensure coverage or payment. For coverage information, verify the appropriate payer's coverage policy.
HCPCS Price Option # Option # Definition Dealer: Dealer City: Dealer Contact:
Dealer Address: Attention:
1. FRAME
o 188WM48 Tilt Release Options
188TO45
Foot Release -(Not Avail. w/ Vent and Battery Tray. May limit folded width, folding frame defaults to right side)
oLeft oRight (facing from rear) Transit Optional
Zippie IRIS Transit Included Includes True fit Growth
$250.00 Transit (For use when Transit Optional frame is selected)
o
188TA6
JAY Cushions (Optional) -5° to 35° (Not available with 12.5" STFH.)
Pre-Set Tilt Angle (40° range) (Default in Bold)
NC 0° to 40°
188TA9
+5° to 45°
JAY Bundled Cushion
NC 188TA8
Price List Depth:
Seat Pan Size
E2231
Custom Seating Drop Seat Pan
Seats (NA w/ Folding Frame) 18"(No Growth wi/Folding B4Me custom set-up)
$200.00 E2231
188ST36
188ST35 Seat Pan-Growable (Fig. 8.1) $200.00
188W7
188WM47 Zippie IRIS Transit Optional
Includes True fit Growth
Base Model(Rocker cover NA with folding)
188TT8 $2,815.00
$2,665.00 Maximum user weight is 225 lbs
1. FRAME o o 10" o 11" o 12" o 13" o 14" o o 15" o 16" o 17" o 18" o o 3" o 2" o 1" o Flush o -1" o -2" o o 2 1/2" or Greater o o Less than 2 1/2" (STD) o
o Below Seat Rail o
o o o o o
4
5
6
8x1 1.58x 8x2 o 13.0 16.0 16.0 o 16.5 16.5 16.5 o 17.0 17.0 17.0 17.0 17.0 17.5 17.5 17.5 15.0 15.0 o 15.5 15.5 o 16.0 16.0 16.5 16.5 16.5 16.5 13.5 o 14.0 14.5 o 14.5 17.0 17.5 17.5 17.5 17.5 18.0 18.0 18.0 18.0 18.0 18.5 18.5 18.5 18.5 19.0 19.0 15.5 16.0 16.0 16.5 16.5 16.5 16.5 16.5 17.0 17.0 17.0 17.0 17.0 16.5 16.5 17.5 17.0 17.0 17.0 17.0 18.0 17.5 17.5 17.5 18.0 18.0 18.0 18.0 17.0 17.5 17.5 17.5 18.0 18.0 18.0 18.0 18.0 18.5 18.5 18.5 18.5 19.0 19.0 19.0
Frame Depth 188FD2 This section determines frame lengthBack Type
2. SIZE / SEATING CONT.
o
Selection A:
Frame Depth Set up By ZippieShort Seat Frame 10"-14"
Top of Cushion to Seat Rail
o
(Choose Selections from A OR B)
NC 188SN01
188FD3 188FD1 188SN03
Selection B:
Frame Depth RangeNC
NC NC Long Seat Frame 14"-18"
Selection B:
Frame Depth11" recommended w/ Short Seat Frame.
Rear Wheel Size
CASTER SIZE 3. CASTERS / SEAT HEIGHT
o $70.00 NC 5" Micro Light Up
Low Poly
Caster Wheel 188CW33 188CW5 188CW51
188CW21 6" Polyurethane $75.00 188CW7 188CW32 188CW34 8" Pneumatic12
$75.00
E2214 E2215 STD $85.00 o 188CW37 E2214 E2215 8" x 2" Pneumatic 188CW39 o 8" Polyurethane 8" x 1.5" Semi-Pneumatic NC 5" x 1.5" Semi-Pneumatic $145.00 $85.00 E2214 E2215 6" x 1.5" Semi-Pneumatic $225.00 $85.00 NC 5" Low-Profile Polyurethane $85.0016
6" Pneumatic4" Micro Light Up (NA with Folding)
22
20
E2214K0108
4" x 1.25" Semi-Pneumatic(NA W/Folding) 188CW31 188CW73 188CW36
NA with Folding
24
NC13" rec. w/ Med. Seat Frame
NC
16" rec. w/ Long Seat Frame 188FD7
Desired Seat Depth
S el ec t fr o m A O R B
12" rec. w/ Short Seat Frame
188FD6
10" recommended w/ Short Seat Frame. Not avail. with Contracture Footrest System
Medium Seat Frame 12"-16"
14" rec. w/ Med. Seat Frame
17" rec. w/ Long Seat Frame
NC 15" rec. w/ Med. Seat Frame
188FD4 NC
12
NC 188FD8 NC 188FD9 NC 188FD518" rec. w/ Long Seat Frame
NC 188SN02
8" x 2" Pneumatic w/Airless Insert 188CW35
Please call customer service for 13.25 on a 12" RW and 4" Caster (Rigid only)
o
1. FRAME o o o o o o o o o o o o o o o o o o o o o Right Left NC Small Handrim
One Arm Drive Axle (Only avail. w/One Arm Drive Option)
NC 188OA2
188AL17 E0958
16" Mag (Not available with handrims) 188AX26
Full Polyurethane (Not avail.w/ 12" & 16" rear wheels)
o
STD 188HM2
Pneumatic Airless Insert o
o Quad Quick Release (not available
with Lite Spokes) 188AX1
188HM1
$200.00 Rear Wheel Size
NC
NC One Arm Drive
Quick Release NC $850.00 Standard Handrim Right NC 188LK02 NC
4. REAR WHEELS / SEAT HEIGHT
One Arm Drive NA with folding frame
188OA1 Wheel Lock $100.00 NC o 188RW91 22" Lite Spoke $100.00 $75.00 6" Pair NC High Mount Push
Not available with Hub Lock
o
Foot Lock(NA w/ One Arm Drive. Folding frame defaults to left side, may limit folded width) 188WL34 o 188RW1 188RW54 20" Mag 188RW8 22" Mag NC 188RW3 NC 188RW14 188AX11 16" Hub Lock
*Only available with 12" or 16" wheels. Not available w/one arm drive. 188HR1
NC
188EH1
E2211 E2213
Low Polyurethane (Only available with 12" wheels )
o
Rear Wheel Tire Pneumatic E2211 E2212 188RT2 $95.00 8 Oblique Extension Handle Hub Lock E0961 Plastic Coated $325.00 o Aluminum Anodized $80.00 Handrim NC
Projections (Not Available on Plastic Coated)
12" Hub Lock 188HM2 188HM1 $125.00 20" Lite Spoke 188RT1 Omit 188WL10 NC 12" Mag (Not available with handrims) 188RW13 188RW90 NC o 188HR8 Left 24" Mag $100.00 188LK01
5. WHEEL LOCKS / HUB LOCK
Only available with 24" Mag wheels & not available with spoke guards. NC 188WL36 o o 24" Lite Spoke 188RT3 NC $200.00 STD 188HR7 NC 188RT4 One Arm Drive(Avail. w/ 20", 22", 24"
Mag Rear Wheels).
Omit (Not available with wheel/axle credit)
NC
188HR4 Axle
1. FRAME
o
o o
o o Leg Strap
o o Extra Single Leg Strap
o o
o
o o Omit Hanger
o Omit Footplate and Ext. Tube
o o o o o o o o o o o o o o o o o o o o o o o o o o o 1" Offset NA with -5-50 ° and -5-35° preset tilt angle and OR possible interference with 80 ° & 90 ° hangers o
o o o o o NC K0040 K0040 $400.00 NC 188E1 K0040 Short 188E2 188E5
Tall Height - Left 188JX02
NC Long
188MZ01
188F6
Standard Hanger Mount 188MZ02
Omit Footplate NC
Z-finity ExtensionTube Length (When Choosing Ext. Tube Mount) 188E62
Medium
K0040 Hemi Short NC
o 188F320 K0040 Multi Angle Adjustable (Pair)
(not avail. w/8"-9" widths) $185.00 o 188F321 K0040 Angle Adjustable Platform Footboard
$150.00
188DI21 Long 3 1/4" NC
Z-finity Footplate
Some interference may exist in certain configurations.
NC 188DI23 Direct Hanger Mt/Fixed Frame - Low
Z-finity Footrest Pivot Arm(Must Choose, use matrix in appendix for leg length)
188DI20 Short 2" NC
Some interference may exist in certain configurations.
188H162 Z-finity Hanger STD
Footrest Hanger Options
K0038
NC
188DI24 Extension Tube Mount NC
Full Foot box w/ Divider Std Ht Full Foot Box
188JX04
Tall Height - Pair 188JX07
$450.00 Standard Height - Pair
$225.00
$400.00 $350.00
Full Foot box w/ Divider Tall Ht Full Foot box Tall Height Toe Loop (Only avail. w/ adult angle adjust. Footplates, NA w/Z-finity)
$30.00
Direct Hanger Mt/Fixed Frame - High
$225.00
$450.00 Tall Height - Right
o
Standard Height - Right
($15.00)
E0952
Neoprene Covers(Only avail. for ext. mount hangers) 188A54 188E5 ($15.00) $35.00 188HL5 $40.00 $30.00 NC $85.00 188A110
Full Foot box Std Height 188JX09
188JX08 o
Standard Height - Left
$225.00 JAY FOOT BOXES
Aluminum (Only available with elevating legrests 14"-18")
Single Foot Box 188JX01 $225.00 NC NC E0951 188IG2 60
°
Swing In/Out o Hanger Mounts 2" (not mounted) 188F9Adult Angle Adj.
(Available with 10"-18" widths) K0040
4" (not mounted)
STD 1" Offset Hanger Mount
Platform Flip-Up (Avail on 60o70oand
80°ext. mount hangers only. NA w/Folding Frame)
188HL1
188H32 $295.00
$150.00
Z-finity Hangers/Footrest System
$350.00 Z-finity Footrest Mount (Must Chose see Illustration in appendix) 188DI22
188JX10 188H10
70
°
Hvy Dty Fnt Mount Lift-Off 80°
Swing In/Out Front Mount 90°
Swing In/Out Front MountComposite (not avail. In 10", 11" or 12" width)
80
°
Hvy Dty Fnt Mount Lift-Off$185.00
Extensions(may interfere with some seat heights & casters)
188H145
$55.00 NC Elev.Fnt Mount (n/a 10-11" wide)
90
°
Hvy Dty Fnt Mount Lift-Off 188H140Hanger Mounted Footrest (Footplates Mount to Hanger Tubing)
NC 188H142
o
o
Ext. Tube Mounted Footrests (Footplates Mount to Ext. Tube) 188H158
Kids Angle Adjustable(not avail. w/17"-18" widths)
188H11 188H161
o
Footboard
(Available with 10"-16" widths)
$185.00
70
°
Swing In/Out Front Mount NC188H9 K0040 188F8 E0990 188E23 188E24 188F62 K0040 188F48 K0040 188F3 188H160 188F4 $185.00 $55.00 STD 188H141 188H159 NC 188E2 $295.00 188E1 K0053 STD Hanger Type (Matrix next page for Ranges)
NC
6. FOOTRESTS (See Appendix for matrix)
E0990
188JX03 $350.00
188JX05 Elevating(Not avail. w/ platform footplates
or < 14" width)
o
K0040
Heel Loops(Z-finity NA widths 10"-14")
o
80
°
Swing In/Out (n/a w/8" Casters) Hanger Type (Matrix next page for Ranges)NC
Only available with Swing Away, Lift-off Hangers ,Adult Angle Adj Footplates and ALR/ELR. Single Foot Box pairs NA with 10"-15" frame widths. Full Foot boxes NA with Heel Loop or Leg Strap or in odd number sizes, Tall Height NA w/ 14"-15" frame widths and ALR/ELR. NA w/ Z-finity.
K0038
Extensions (Matrix next page for Ranges)
188JX06 K0037 188H139 188F5 188E16 o 188F1 o Footplate High Mount Medium
Kids Angle Adjustable(not avail. w/17"-18" width) 70
°
Swing In/Out $185.00 Short NC Long K0040 NC Articulating (not avail. 10"-13")$55.00 Footplate
$190.00 STD
NC
Adult Angle Adjustable (Available with 10"-18" widths)
(Maximum weight capacity for Z-Finity footrests is 165 lbs) 188F7
1. FRAME o o o o o o o o o o o o o o o o o
Backrest Name or Part #
o o o o Select One o
AND Select desired Push Handle o o o o o o o o o $850.00 Mono Backrest System w/Dynamic
Backrest
NC $995.00 o
$175.00
Contracture Footrest System (CFS)
NA w/ Neoprene Impact Guards, Kids Angle Adj. Aluminum Footrests, Dual Post Armrest or Folding Frame. 6. FOOTRESTS CONT. (See Appendix for matrix)
Folding Adjustable Rigidizer NA w/ Mono Back
C. Mono Back System
NC E1225 188EP9 188PH9 14.5" Extension Height 188PH8 188BT21
Long Angle Adj. Push Handle Length
Medium (21" Height) Std. Angle Adj. Push Handle Lgth
Reclining Backrest
NC JAY Bundled Backrest
Width: Height:
NC
$395.00 Mono Backrest System
Price List
Std. Angle Adj. Push Handle Lgth NC
188B172
Only available with 40° Tilt Range. NA w/Folding Frame NC 188PH8 188MO2 Tall (24" Height) 188MO1 NC 188EP8 D. Reclining Backrest Medium (22" Ht) NC Tall (19"-25" Height.) 188BP11 10.5" Extension Height 7. BACKREST / SEATING 188B173 188BP10 NC A. Fixed Height Low (19" Ht) o OR 188JB02 Dynamic Backrest
NA w/ Reclining or Folding Frame. NA in some configurations. B Height Adjustable 188EP1 NC DYNAMIC BACKREST 188RG1 Tall (25" Ht) OR Std. (16"-22" Height.) NC 188E1 11.0" Extension Height 13.0" Extension Height 188BP9
Rigid Back w/ Angle Adjust Push Handle
STROLLER HANDLE BACK POSTS - BACK RESTS (Choose A, B, C or D)
188PH8 188EP4 NC 188EP2 $325.00 REGULAR NC 188E2 NC NC NC 188B170 12.0" Extension Height 12.5" Extension Height 188EP6 188EP5 188EP7 11.5" Extension Height CFS - Outside Mount 188BP13 188FP02 NC 188EP3 NC NC 188EP5 SHORT 12.5" Extension Height OR NC
Must select JAY J3 when ordering Mono Back. NA w/ Folding Frame. NC 13.0" Extension Height 14.0" Extension Height NC NC 15.0" Extension Height 13.5" Extension Height 188EP10 188EP6 188FP01 CFS - Center Mount NC NC
Jay Backs (Optional)
Ordering JAY backs on-chair, See the JAY Price List. Requires Part #
NC
NC
o 188PH9 Long Angle Adj.
Push Handle Length NC
Std. Angle Adj. Push Handle Lgth 188B171
o 188PH9 Long Angle Adj.
Push Handle Length
188H26 Contracture Footrest System NC
188BT101 o $1,195.00 o $85.00 Removable Extension
A
C
D
A
B
1. FRAME o o o o o o o o o o o o o o o o o o o o o o o o o o $805.00 $545.00 $260.00 $805.00 Select desired Lateral (optional)
$260.00 $805.00 $545.00 $310.00 $310.00 188JP06 E2615 188JP08 E1028 188MH16 $745.00
Axys Mount & Bracket 188JB05
o
$535.00
188HE66 E2613
JAY J3 Backrest Contour
$230.00
$545.00 J3 PA Back(2.2" of Contour Depth)
NC See OF $280.00 $200.00 $545.00 $260.00 $805.00 $260.00 $545.00 188MH10 $260.00 $260.00 $805.00 $260.00 Adjust-A-Plush Narrow
E1028 LATERAL SWING AWAY MOUNT - PAIR
LAT 4X6 S/A MOUNTS includes 1" OFFSET - PR
$260.00 LAT 4X5 S/A MOUNTS includes 1" OFFSET - PR
NC
NC
E0955
Plush Head Support Pad 10"
$805.00 $545.00 Onyx Mount and Bracket
NA on Folding Frame, Vent/Battery Tray Base(LTV only), Reclining Backrest, Desk Length Armpads, Canopy and 10"-11" frame widths and depths.
o
Mono Height Adj. Handle Height Diagram
$620.00 $745.00 188JP10
o
E2620 J3 PDC BackNA w/ 12" width(6.0" of Contour Depth)
188JR08 188JP09
J3 PL Back(3.0" of Contour Depth)
SH Medium 22.5" NA w/ 12" width
o 188JR07
188JR10
Select desired Headrest Pad (optional)
188HE88
Plush Head Support Pad 8" E0955
JAY J3 via JAY Your Way
JAY J3 Back for Mono Backrest System Cont.
JAY J3 Backrest Height o
HeadsUp Lrg: 5.3" Lng Arms
SH Standard 21" Shell Height NA w/ 12" width
HeadsUp Med: 4.1" Sht Arms 188MH15
E0955 E1028
LAT 4X4 S/A MOUNTS includes 1" OFFSET - PR UT Medium 18" shell height
NA w/ 12" width
E0955
$230.00 o
188MH17 J3 PDL Back(6.0" of Contour Depth)
NA w/ 12" width
E0955
Cobra Mount and Bracket
NC $230.00 188HE87 E0955 Omit 188HE65 $230.00 188HE78 $310.00 Plush Head Support Pad 14"
Adjust-A-Plush Standard E2620
UT Tall 19.5" shell height NA w/ 12" width
E1028
E0955
NC
188HE89 E0955 HeadsUp Sml: 3.5" Sht Arms
E1028
188ZV14 E0956 LATERAL 4X4 W/ 1" OFFSET - PAIR 188HE83
LATERAL SWING AWAY MOUNT - PAIR
o 188JR09
188ZS07
LATERAL 4X6 W/ 1" OFFSET - PAIR 188ZS07 E1028 LATERAL SWING AWAY MOUNT - PAIR
188ZV15 E0956 LATERAL 4X5 W/ 1" OFFSET - PAIR
Some interference may exist w/ armrest when ordering a backrest
width greater than 4" wider than the base. LAT 6X4 S/A MOUNTS includes 1" OFFSET - PR 188ZS07
188ZV17
188ZV16 E0956
JAY J3 Backrest Width
o 188JR12
188ZS07
LAT 6X5 S/A MOUNTS includes 1" OFFSET - PR E1028 LATERAL SWING AWAY MOUNT - PAIR
E0956 LATERAL 6X4 W/ 1" OFFSET - PAIR
188ZV19 JAY J3 Backrest Color
LAT 6X6 S/A MOUNTS includes 1" OFFSET - PR 188ZV18 E0956 LATERAL 6X5 W/ 1" OFFSET - PAIR
LATERAL SWING AWAY MOUNT - PAIR
188ZS07 E1028
LATERAL 6X6 W/ 1" OFFSET - PAIR E0956 14" Backrest Width NC NC 18" Backrest Width 188JR11
Match Frame- Standard Colors
NC NC JAY J3 Back for Mono Backrest System
LATERAL SWING AWAY MOUNT - PAIR
188ZS07 E1028
o
UT Standard 16.5" shell height
7. BACKREST / SEATING CONT.
Select desired Headrest Mount (optional) See OF 188HE82 o NC NC 188GZ01 188JQ01 NC 188JQ03 o 188JQ06
Match Frame- Custom Color 188GZ02 $50.00 SH Tall 24" NA w/ 12" width Black 188GZ03 188JQ02 16" Backrest Width
188JB04 JAY J3 Back Mono
Mono Backrest Options ONLY
12" Backrest Width
(only avail w/UT Standard 16.5" shell ht) NC
1. FRAME o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o 188JN04 Plastic Std 188AM24 NC 188AM23
Swing Away - Rotational (Pair)
Low E1028 $500.00 NC Full Contour ARMPAD $125.00 188AR18 NC Plastic Low NC Full Classic 188JN03 Fixed (EA)
Arm Trough - 18" long - Left $205.00
188JL08 188JL09 o $205.00 188JL03 188JL07 188JN01 188JL02 E2209 E2209 NC $205.00 E2209 Side Guard $250.00 E2209 $205.00 $410.00 Fixed (Pair) NC
188JN02 E1028 Swing Away - Rotational (EA)
$410.00 Arm Trough - 18" long - Right
JAY Arm Troughs
E2209
Not available with height adjustable armrests, T Posts or Cantilever armrests. NA w/ Mono Back.
K0108
$125.00 Arm Trough - 18" long - Pair
E2209 188JL04
$410.00 188JL05 Arm Trough - 14" long - Pair
Arm Trough - 14" long - Right
NA with Length Adj. Locking Flip Up and Adj Locking Flip Up armrests and Single Post Height Adj Armrests. Full Length Classic Armpads will automatically
be selected when chosing only one side Arm Trough.
188AA62
Length Adjust. Locking Flip-Up
NA with Contour Armpad $265.00
NC
Foam Long
Contour only w/ Single Post Height Adj. Foam only Lengh Adj. 188AA63
188AA7
188AA11
Dual Post Flip Back 188AA48
E2209
NC E0973
E0973 Single-Post Height Adj. Std. Single-Post Height Adj. Low
JAY Arm Trough - Hardware Arm Trough - 22" long - Right E0973
$205.00
$285.00
Foam Short
Height Adj. Cantilever ArmrestAvail. w/ Mono Back only. NA w/ 20", 22" and 24" rear wheels. $250.00 188SG29 K0108 188SG33 188AM22
Arm Trough - 22" long - Left Arm Trough - 22" long - Pair
Pad Length L Desk 188AM9 NC 188AR17 188AA12 188JL01 188AA1 188AA3
E0973 T-Post Tall w/Foam
Std
Armrest Receiver for Single Post Height Adjustable Armrest 188AM21
Dual Post not available with 0 - 13" deep or with 14 - 15" deep seat pan, Dual Post also not available with contracture Footrest. Some interference may exist in some configurations.
E0973 188AA43 E0973 $255.00 $270.00 188AM10 E0973
Armrest - Height Adjustable
$295.00 E0973
E0973
$95.00
o
Arm Trough - 14" long - Left T-Post Regular w/Foam
Dual Post E2209 Full NC $205.00 Flip-Up Desk Full 188JL06 188AA13 NC
8. ARMRESTS / SIDE GUARDS
E2209
Dual Post Flip Back Height Adj. 188AA29 188AA154 E0973 Desk Contour $285.00 NC Adjustable Locking Flip-Up
NC NC Armrest Size Transfer Tube Length D Receiver Desk Classic H Range CLASSIC PAD Dual Post Height Adjustable
STD 8" STD 10 3/4" to 15 3/4" 10 1/4" 14" LOW 8 3/4" to 13 3/4" LOW 5 1/4" 6 3/4" to 10 3/4" STD 9" to 13" LOW 7 1/4" to 11 1/4" Receiver CONTOUR PAD
H Range Pad Length L
Armrest Matrix for Single Post STD 10" to 15"
10 1/2" 14 1/4" LOW 8 1/4" to 12 1/2"
STD 8 1/2" to 12 1/2" LOW
1. FRAME o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o Blue Opal o o Candy Blue o o o o o o o o o o o o o o o
JAY Padded Trunk Strap 188JA01
Classic Structure 188JY03
Dovetail Vertical Frame Mounted Hardware for LTV Vent (limit 15#) includes 1 Utility Hook. Must remove for folding.
$495.00 $120.00 188A1
JAY Anterior Thoracic Support
188JY04 Positioning Belt (w/clamps)
188JY05
Canopy (SunShade)
$187.00 Classic Dynamic
Need 2" back post clearance to mount canopy hardware, may require next height based on seating; please note some interference may occur with some headrest configurations. NA
with Mono Back. Must remove for folding. 1888A06
$187.00
188JA02 Padded Trunk Strap - Medium
188JZ01
Center Opening with Buckle
188JA04
$187.00
o $187.00
$187.00 Padded Trunk Strap - Large
188JA03 Large NC NC E0978 $187.00 NC
Padded Trunk Strap - XL 188LF7
188A29 $115.00
$115.00 Not available with 12" & 16" rear wheels & Projections Handrims
Black Size Small $187.00 Medium NC 188JZ04 188AT1 Anti-Tip
Padded Trunk Strap - Small Contour Dynamic
X-Large
Med (Suggested 15"-17" Width)
188JZ03
$495.00
Upper Extremity Support Tray 188LF13
188A30 Sm (Suggested 13"-14" Width) $250.00
$250.00 o Contour Structure $187.00 NC Rootbeer Utility Hook $25.00
Matte Black Cherry
188C8 E0950 $250.00 188C147 Black Opal $275.00 K0108 $275.00 Canopy (Sunshade) 10"-14" Width
K0108 $187.00 Style 188JY02 188A31 Spoke Guard K0065 E0950 188JZ02 188C142 E0950 188C150 Custom Colors NC Electric Blue Evergreen Glow Candy Purple E0978 Yellow
Black (Not avail as base w/Zebra)
10. FRAME COLOR 188C145 188C114 NC NC 188C113
Hot Sparkle Pink
NC NC 188C149 188C152 NC NC Candy Red NC 188A32 188C144 Green Apple 188C143 Lrg (Suggested 18"-20" Width) 188C35 188C126 188C140 188C141 188C2 Standard Colors 188C14 $295.00 $295.00 NC
Matte Electric Blue
NC $295.00 Matte Black NC 188C116 188C151 Matte Purple 188C103
Standard Matte Colors
NC NC Aztec Gold NC NC NC Mauve Pink NC $45.00 All Zippie chairs ship with one Kids Backpack at NC
188A83
188JY01 Black
$140.00 E0971 Rear Anti-Tip
Back Pack (Kids Backpack included)
188A117
Miscellaneous 188A2
E0978
Additional Zippie Backpack
188A8 188A112 E0978 $110.00 E0978 $45.00 188A118 $70.00 188A141
Belt 2" Aircraft Buckle
$85.00 Tool Kit
1" DualPull Side Squeeze Padded
188A303 K0065
188A23
E0950 X-Sm (Suggested 10"-12" Width) Clear Zippie
When ordering a tray with full armrest or desk armrest pads, add 1" to seat width to determine best tray size. NA with JAY Arm Trough. Must remove for folding.
E1029
JAY 2 Pt Anterior Pelvic Belt 1" Push Btn
$250.00 Belt 2" Aircraft Buckle Padded
Dovetail Vertical Frame Mt Hardware for Trilogy Vent (limit 15#) includes 1 Utility Hook Must remove for folding.
$120.00
Vertical Mount Vent Tray-Back cane Mount 188A814
188LF12 E1029
Zebra(Choose base color above: White Std, n/a black)
Titanium Color Paint
NC NC Sparkle Silver Sunrise Orange 188C36 188C10 188C38 Black Cherry NC
Mossy Oak Camouflage
NC NC
Matte Evergreen
188C42 NC
Stars and Stripes 1888A07
Utility Backpack - Black
Belt 1.5" Auto Buckle w/Clamps
$55.00
Seat Pouch
188C148
9. ACCESSORIES
188C43
Canopy (Sunshade) 15"-20" Width $50.00
o 188C108
1. FRAME
Commonly Requested Options Include: Reverse Configuration
Angle Adjustable Handle for Reclining Backrest Dual Mount Wheel Locks - Attendant Foot Lock Dynamic Back on Frame Depth up to 20" O2 Holder with Transit
IV Pole with Transit
Solid Seat w/ Quick Release Hardware for folding frame Z-finity Matrix
Direct Hanger Mount Extension Tube Mount
APPENDIX
Lower Leg Length Matrix
To inquire about any unique customization for Quickie products, contact: Phone: (800) 333-4000, Fax: (800) 333 9011
Additional Options Through Built for Me
Min Max No Ext 3 1/2 9 11 1/2 2" 3 1/2 11 1/2 13 1/2 4" 3 1/2 13 1/2 15 1/2 No Ext 3 1/2 9 1/2 11 1/2 2" 3 1/2 12 14 4" 3 1/2 14 16
90° Front Mount No Ext 3 9 11 1/2
ELR Front Mount No Ext 3 7 10 1/2
Short 9 12 1/2 12 1/2 Med 9 14 1/2 12 1/2 Long 11 1/2 16 14 1/2 Short 10 1/2 15 1/2 12 1/2 Med 10 1/2 17 1/2 13 Long 13 1/2 19 15 Short 11 14 1/2 13 Med 11 16 1/2 13 Long 13 18 15 Short 14 17 1/2 12 1/2 Med 15 19 1/2 13 1/2 Long 16 1/2 19 14 1/2 Short 13 17 12 1/2 Medium 13 18 1/2 13 1/2 Long 14 1/2 20 14 1/2 Min Allowable FSH 60° Swing In/Out 70° Swing In/Out 80° Swing In/Out 80° Front Mount 70° Front Mount
ELR Ext. Mount ALR
Seat Pan to Top of Footrest Extension Hanger Footrest Adaptor Extension Tube Length Min Max Hemi Short 3.9 12.4 Short 4.9 13.4 Medium 6.6 15.4 Long 8.6 17.4 Hemi Short 2.6 13.6 Short 4.1 14.6 Medium 5.6 16.6 Long 7.6 18.6
Extension Tube Mounted
Short Long Footrest Adaptor Hanger Mounting Position Min Max Low Mount 2.6 6.7 Long High Mount -2.1 4.6 Low Mount 1.3 7.9
Direct Hanger Mounted
Short
High
