Invacare Ltd Manual Prescription Form
Pencoed Technology Park Dealer Prescription Form
Pencoed CF35 5AQ LPF1U2READAHLIA140515Dealer
Tel: +44 (0) 1656 776222 Fax: +44 (0) 1656 776220
July 2015
email: ordersuk@invacare.com
Customer Name : Account No :
Address : Order No :
Order Qty : Tel Number :
Delivery Address : Order Date :
please make your selection with a cross in the box Standard feature Free of Charge (NC9999) non conformance with option 9999
Î Customer weight = Kg
Code Description NC's (Non Conformance) Dealer
BXA0015 X Rea Dahlia 45° £2,026
BXA8000 Rea Dahlia 45°Special Basic Model - PLEASE COMPLETE DETAILS AT THE END OF THE FORM POA
PROPULSION TYPE
BXA0020 Equipped with 16" transit wheels inc. hub brakes
SEAT DIMENSIONS
SEAT WIDTHBXA0050 390mm (15") ( Small chassis)
BXA0060 440mm (17") ( Medium chassis)
BXA0070 490mm (19") ( Large chassis) (NC: 0330)
SEAT WIDTH ADJUSTMENT (PRE ADJUSTMENT)
BXA0080 + 50mm seat width pre adjustment
BXA0090 + 100mm seat width pre adjustment
BXA0100 No seat width extension (NC: 0420; 0430)
BXA0110 X 430 - 500mm (17" - 20")
SEAT DEPTH ADJUSTABLE For up to date spare parts online, please visit www.invacare.co.uk
Invacare
®REA Dahlia 45
°
Transit
Dealer
Max User Weight 135Kg (21 stone)
Due to how highly configurable the REA Dahlia is please refer to the following guide to help highlight the combination of options that are available.
Standard Features:
Transit Propulsion 16" Solid Tyre with Attendant Hub Brakes Choice of Seat Widths 390mm to 490mm (+50mm and +100mm)
Choice of 4 Seat Heights 350mm - 500mm (14" - 20") Depth Adjustable Seat 430mm-500mm (17" - 20")
Flex 3Backrest Plate, Passad 2 Cushion with Connected Push Handles
Assistant Operated Gas Piston Seat and Backrest Recline with Tilt Lock 80° Fixed Legrests Swing In Swing Out
Height Adjustable Standard Armrests (including autolock) Sideways Adjustable Neckrest
Black Frame User Manoeuvred Tyre Brakes
Solid Tyres
Pelvic Belt, Transportation Brackets, Anti Tippers
SEAT HEIGHT
BXA0120 350mm (14") available with 16" rear wheels (NC: 1400; 1410; 1420; 1430; 1440; 1450; 1470)
BXA0130 380mm (15") available with 16" rear wheels (NC: 1390; 1410; 1420; 1430; 1440; 1450; 1470)
BXA0170 480mm (19") available with 16" rear wheels (NC: 1390; 1400)
BXA0180 500mm (20") available with 16" rear wheels (NC: 1390; 1400; 1410; 1420; 1430)
SEAT TILT ANGLE
BXA0200 X Positive Seat angle 45º
BACKREST RECLINE ANGLE
BXA0207 X Backrest recline 30º
SEAT CUSHION
BXA0230 Cushion Floshape £45
BXA0280 Without seat cushion
SEAT UPHOLSTERY
BXA0290 Black plush TR35
BXA0300 Black dartex TR26
BACKREST TUBES
BXA0310 20° angled tubes, bent 380mm above seatplate (to fit Matrx backrests) (NC: 0390; 0400; 0550; 0560)
BXA0320 Straight tubes (to fit Flex 3 and Matrx)
BACKREST RECLINE PIVOT JOINT
BXA0330 50mm width extension £67
BXA0340 Without width extension
FLEX 3 BACKREST
BACKREST TYPEBXA0390 Backrest plate - Flex 3 width and height adjustable (NC : 0450)
BXA0400 Tension adjustable - Flex 3 width and height adjustable (NC : 0420; 0430; 1250) £80
BXA0410 Backrest tubes without backrest
(NC: 0420; 0430; 0450; 0460; 0470; 0480; 0490; 0520; 0530; 1040; 1050; 1060; 1070; 1080; 1090; 1100; 1110; 1120; 1130; 1200; 1210; 1220; 1230; 1240; 1250)
FLEX 3 BACKREST WIDTH ADJUSTMENT (PRE ADJUSTMENT)
BXA0420 +50mm width pre adjustment
BXA0430 +100mm width pre adjustment
BXA0440 Without width pre adjustment
BACKREST COVER/ CUSHION
BXA0450 Cover, Lateral for tension adjustable upholstery
BXA0460 Cushion, Laguna (lateral support)
BXA0470 Cushion, Mistral 2 (waist support) £113
BXA0480 Cushion, Passad 2 (shoulder support)
BXA0490 Cushion, Shoulder High 05 (dartex) (NC: 0520) £118
BACKREST UPHOLSTERY
BXA0520 Black plush TR35
BXA0530 Black dartex TR26
HEIGHT ADJUSTABLE PUSH HANDLES
BXA0540 Push bar, angle adjustable £80
BXA0550 Push handles divided
BXA0560 Push handles connected
SEATING
SEAT TILT TYPEBXA0580 Assistant hand operated gas piston seat tilt
BACKREST RECLINE REGULATION TYPE
BXA0600 Assistant operated gas piston for backrest recline
LEGRESTS / FOOTRESTS
CENTRAL LEGRESTS TYPEBXA0630 Central legrest, incl calfpad and footrest. Not to combine with separate
footrest lower parts, abduction cushion, footplate extender and clinic kit.
(NC : 0650; 0660; 0670; 0680; 0690; 0710; 0720; 0730; 0740; 0760; 0770; 0790; 0810; 0830; 0850; 1010; 1270; 1280; 1300; 1310; 1800)
£239
LEGREST/HANGER POSITION
BXA0640 Low position, standard
BXA0650
LEGRESTS / HANGERS LH TYPE
BXA0660 Hanger angle adjustable - alu 2008 LH. With knee pad and calf support (NC : 1290) £78
BXA0670 Hanger fixed 80º, swing in swing out - alu 2003, LH
BXA0680 Hanger fixed 90º, swing in swing out - alu 2003, LH (NC : 0810; 1270; 1310; 1390; 1440; 1450; 1470)
BXA0690 Legrest amputee - alu 2008 LH (NC : 0760; 0770; 0790; 0810; 1270; 1280; 1290; 1300; 1310) £108
If selecting this option on the Tension adjustable backrest, the +50mm seat width adjustment must also be selected
LEGRESTS / HANGERS RH TYPE
BXA0710 Hanger angle adjustable - alu 2008 RH. With knee pad and calf support (NC : 1290) £78
BXA0720 Hanger fixed 80º, swing in swing out - alu 2003, RH
BXA0730 Hanger fixed 90º, swing in swing out - alu 2003, RH (NC : 0850; 1270; 1310; 1390; 1440; 1450; 1470)
BXA0740 Legrest amputee - alu 2008 RH (NC : 0760; 0770; 0830; 0850; 1270; 1280; 1290; 1300; 1310) £108
FOOTRESTS ONE PIECE
BXA0760 Footrest one piece depth and angle adjustable short tube (NC : 0790; 0810; 0830; 0850) £93
BXA0770 Footrest one piece depth and angle adjustable long tube (NC : 0790; 0810; 0830; 0850) £93
FOOTRESTS LH TYPE
BXA0790 Footrest lower part, depth and angle adjustable with short tube and heel
strap, LH (NC : 1290)
BXA0810 Footrest lower part, depth and angle adjustable with long tube and heel
strap, LH (NC : 1290)
FOOTRESTS RH TYPE
BXA0830 Footrest lower part, depth and angle adjustable with short tube and heel
strap, RH (NC : 1290)
BXA0850 Footrest lower part, depth and angle adjustable with long tube and heel
strap, RH (NC : 1290)
ARMRESTS
ARMRESTS LH TYPEBXA0870
BXA0880 Height adjustable wide pad, LH
Only combine with 16" rear wheels (Autolock armrest included)
BXA0890 Hemiplegic armrests, LH. Not possible to combine with standard table.
(Autolock armrest included) (NC : 0980; 1710; 1720; 1730; 1740; 1750) £141
ARMRESTS RH TYPE
BXA0930
BXA0940 Height adjustable wide pad, RH
Only combine with 16" rear wheels (Autolock armrest included)
BXA0950 Hemiplegic armrests, RH. Not possible to combine with standard table.
(Autolock armrest included) (NC : 0980; 1710; 1720; 1730; 1740; 1750) £141
SEATING OPTIONS
ARMREST OPTIONSBXA0980 Pad for siderest, removable with velcro £40
SEAT OPTIONS
BXA0990 Incontinence cover £31
BXA1000 Abduction/Pommel cushion (NC : 1020) £93
BXA1010 Seat plate extension plates, 2 pieces. Width, forward, rear or assymetric £33
BXA1020 20mm increased seat height plate £50
BXA1030 Scale for seat tilt £35
BACKREST OPTIONS
BXA1040 Headrest, sideways adjustable (NC : 1060; 1070; 1072; 1080)
BXA1050 Cover for headrest (NC : 1060; 1070; 1072; 1080) £25
BXA1060 Headrest with cheek support, sideways adjustable (NC : 1070; 1072; 1080) £85
BXA1070 Neckrest
BXA1080 Cover for neckrest £16
BXA1085 3rd Party headrest bracket £15
BXA1090 Handles clinic kit for head/neckrest £38
BXA1100 Trunk support multi adjustable with standard arm (LH) (NC : 1220)
BXA1110 Trunk support multi adjustable with standard arm (RH) (NC : 1220)
BXA1120 Trunk support multi adjustable with extended arm in height (LH) (NC : 1220)
BXA1130 Trunk support multi adjustable with extended arm in height (RH) (NC : 1220)
BXA1200 Trunk support multi adjustable swingaway (LH) (NC : 1220) £89
BXA1210 Trunk support multi adjustable swingaway (RH) (NC : 1220) £89
BXA1220 Trunk support attachment
BXA1230 Lumbar support cushion £24
BXA1240 Wedges (one pair) £8
BXA1250 Privacy attachment (material connecting backrest and seat) £26
BXA1260 Scale for backrest recline £35
LEGREST OPTIONS
BXA1270 Footplate extender LH (NC : 1300) £26
BXA1280 Footplate extender RH (NC : 1300) £26
BXA1290 Heel strap (for one piece footrest)
BXA1300 Pad for footrest £42
BXA1310 Calf strap padded £57
Height adjustable, Dartex padded ducktail pad, LH (Autolock armrest included)
CASTOR ATTACHMENT TYPE
BXA1370 Fixed
FRONT CASTORS
BXA1390 100mm x 27mm (4" x 1") medium hard
BXA1400 125mm x 27mm (5" x 1") medium hard
BXA1410 140mm x 37mm (5.5" x 1.5") soft £15
BXA1420 150mm x 27mm (6" x 1") medium hard £15
BXA1430 150mm x 30mm (6" x 1.25") soft
BXA1440 200mm x 27mm (8" x 1") medium hard
BXA1450 200mm x 30mm (8" x 1.25") soft
BXA1470 200mm x 45mm (8" x 1.75") medium hard
REAR WHEEL ATTACHMENT TYPE
BXA1490 Fixed
REAR WHEEL TYPE/SIZE
BXA1500 16" Transit
TYRE TYPE
BXA1560 Pneumatic block pattern tyre
BXA1580 Solid PU tyre
SAFETY
BRAKE TYPEBXA1680 X User manoeuvred tyre brakes
SAFETY OPTIONS
BXA1690 X Pelvic belt
BXA1700 Reflectors kit (wheels and chassis) £16
ACCESSORIES
BXA1710 Table tray incl mounting kit (NC : 1750) £109
BXA1720 Table tray cushion (NC : 1730; 1750) £40
BXA1730 Swing away table (NC : 1740; 1750) £153
BXA1740 Locking device for table tray (NC : 1750) £11
BXA1750 Mounting kit for table (if ordered separately) £6
BXA1780 Pump £16
BXA1790 Cane holder £39
BXA1800 Clinic kit £43
BXA1810 Harness attachment bracket (pair) on seat £17
BXA1820 Harness attachment bracket (pair) upper £17
BXA1830 Tipping lever (NC : 1860) £33
BXA1850 X Transportation brackets
BXA1860 Accessories tray (to suit Ventilators etc. Positioned at the rear of frame between rear wheels) £208
SPECIALS
BXA8010 Special Comment PLEASE COMPLETE DETAILS AT THE END OF THE FORM
TOTAL PRICE
Non Conforming Options:
BXA0330 + 50 mm Backrest joint position
BXA0390 Flex 3 backrest, plate width adjustable
BXA0400 Flex 3 backrest, tension adjustable width adjustable
BXA0410 Backrest tubes without backrest
BXA0420 Flex 3 + 50 mm Backrest adjustment
BXA0430 Flex 3 + 100 mm Backrest adjustment
BXA0450 Cover, Lateral
BXA0460 Cushion, Laguna (lateral support)
BXA0470 Cushion, Mistral 2 (waist support)
BXA0480 Cushion, Passad 2 (shoulder support)
BXA0490 Cushion, Shoulder High 05 (dartex)
BXA0520 Black Plush TR35 Backrest upholstery
BXA0530 Black Dartex TR26 Backrest upholstery
BXA0550 Push handles divided
BXA0560 Push handles connected
BXA0640 Low position Standard
BXA0650 High position, mounted 50mm higher
BXA0660 Hanger angle adjustable - alu 2008 LH. With knee pad and calf support
BXA0670 Hanger fixed 80 deg, swing in swing out - alu 2003, LH
BXA0680 Hanger fixed 90 deg, swing in swing out - alu 2003, LH
BXA0690 Legrest amputee - alu 2008 LH
BXA0710 Hanger angle adjustable - alu 2008 RH. With knee pad and calf support
BXA0720 Hanger fixed 80 deg, swing in swing out - alu 2003, RH
BXA0730 Hanger fixed 90 deg, swing in swing out - alu 2003, RH
BXA0740 Legrest amputee - alu 2008 RH
BXA0760 Footrest one piece depth and angle adjustable short tube.
BXA0770 Footrest one piece depth and angle adjustable long tube.
BXA0790 BXA0810 BXA0830 BXA0850
BXA0980 Pad, side rest
BXA1010
BXA1020 2 cm seat height increased seat plate
BXA1040 Headrest, sidewise adjustable
BXA1050 Cover for headrest
BXA1060 Headrest with cheek support, sidewise adjustable
BXA1070 Neckrest
BXA1072 3rd party headrest bracket
BXA1080 Cover for neckrest
BXA1090 Handles clinic kit for head-/neckrest
BXA1100 Trunk support multi adjustable with standard arm (LH)
BXA1110 Trunk support multi adjustable with standard arm (RH)
BXA1120 Trunk support multi adjustable with extended arm in height (LH)
BXA1130 Trunk support multi adjustable with extended arm in height (RH)
BXA1200 Trunk support multi adjustable swingaway (LH)
BXA1210 Trunk support multi adjustable swingaway (RH)
BXA1220 Trunk support attachment
BXA1230 Lumbar support cushion
BXA1240 Wedges (one pair)
BXA1250 Privacy attachment
BXA1270 Footplate extender LH
BXA1280 Footplate extender RH
BXA1290 Calf strap (for footrest one piece)
BXA1300 Foot plate padding
BXA1310 Calf support padded
BXA1390 100x27 medium hard (4") front castor
BXA1400 125x27 medium hard (5") front castor
BXA1410 140x37 soft front castor
BXA1420 150mm x 27mm medium hard castor
BXA1430 150x30 soft front castor
BXA1440 200x27 medium hard front castor
Footrest lower part, depth and angle adjustable with long tube and heel strap, LH Footrest lower part, depth and angle adjustable with short tube and heel strap, RH Footrest lower part, depth and angle adjustable with long tube and heel strap, RH
Seat plate extension plates, 2 pieces. Width, forward, rear or assymetric Footrest lower part, depth and angle adjustable with short tube and heel strap, LH
BXA1710 Table tray incl mounting kit
BXA1720 Table cushion
BXA1730 Swing away table
BXA1740 Locking device for table tray
BXA1750 Mounting kit for table (if ordered separately)
BXA1800 Clinic kit
BXA1860 Accessories/Ventilator tray
Special Instructions: Please supply the following information
Name: Email: Phone:
