1. ACCOUNT INFORMATION
Please provide the following details to process your order:
Important: The order cannot be processed without the following: A user name or number, the client's measurements and weight. Amysystems is not responsible for configuration or size discrepancies resulting from customer errors on the order form. Order confirmations will be provided by Amysystems summarizing the items selected. Please review this carefully. Once the order is shipped, any changes are subject to the returns policy and may be prohibited.
Items highlighted in red indicate new options, upgrades, pricing modifications, or added notes.
2. STANDARD OPTIONS
Alltrack P3 Power Base:
- 6-wheel independent wheel suspension
- Additional seat suspension system
- Tie-down hardware for strap systems
- 8A offboard charger
- 6" front casters on MWD or 8" on HWD
- Standard auto-style buckle seat positioning strap
- 6.5mph motors
- Weight Capacity = 300 lb
3. ALLTRACK P3 POWER WHEELCHAIR
MID-WHEEL DRIVE CONFIGURATION
| ATPM3 | ALLTRACK P3 Power Wheelchair (MWD) | $8,020 |
HYBRID-WHEEL DRIVE CONFIGURATION
| ATPR3 | ALLTRACK P3 Power Wheelchair (HWD) | $8,020 |
3.5 OWNER'S MANUAL
| SOOMATENG | English / Anglais | N/C | SOOMATFR | Français / French | N/C |
4. USER WEIGHT PACKAGES
| WCA25 | 250 lb Maximum user weight capacity | STD |
| WCA3 | 300 lb Maximum user weight capacity | STD |
5. STANDARD COLORS
| SCMOBM / SCROBM | Onyx Black Matte | N/C | SCMCAB / SCRCAB | Cabernet | N/C |
| SCMCTB / SCRCTB | Cobalt Blue | N/C | SCMBGM / SCRBGM | Bubble Gum Metallic | N/C |
| SCMIOB / SCRIOB | Indigo Blue | N/C | SCMHAB / SCRHAB | Habanero Metallic | N/C |
| SCMCRE / SCRCRE | Candy Red | N/C | SCMLIM / SCRLIM | SubLime | N/C |
OPTIONAL COLORS
| FCHDD-M / FCHDD-R | Desert Digital Camo HydroGraphics - (Military Tan base) | $795 |
| FCHWL-M / FCHWL-R | Woodland Camo HydroGraphics - (Military Green base) | $795 |
| FCHCF-M / FCHCF-R | Carbon fiber HydroGraphics - (Matte black base) | $795 |
5.5 WHEEL INSERT COLORS
| SCCTB-WI | Cobalt Blue | N/C | SCHAB-WI | Habanero Metallic | N/C |
| SCIOB-WI | Indigo Blue | N/C | SCLIM-WI | SubLime | N/C |
| SCCRE-WI | Candy Red | N/C | SCBGM-WI | Bubble Gum Metallic | N/C |
Wheel insert colors are not compatible with optional Hydrographic colors (FCHDD, FCHWL and FCHCF).
Wheel insert colors are not compatible with the optional 14" x 4" Extra Wide Cast Wheels (DW144PT and DW144PI).
Wheel inserts are not available in Onyx Black Matte.
7. TRANSPORT OPTION
| TTD4 | 4-Point wheelchair transport brackets | STD |
| WC19-ISO | WC-19 and ISO 7176-19 Occupied Transit Package | CLIENT COST $595 |
4-Point wheelchair transport brackets have not yet received WC-19 crash-testing approval.
To confirm if your overall wheelchair configuration is WC-19 and ISO 7176-19 compliant, please refer to this website: https://docs.google.com/spreadsheets/d/1KtcNIEA5OQJCS5z3OD1adWEIaFLN1XO3ZcTc6Dl_kaE/edit#gid=1917752765
Other restrictions may apply, please contact CSR for details.
This option is only available on new power wheelchairs as an "on-chair" option. It is not available to install on a delivered wheelchair.
Not compatible with the narrow base configurations (FS2424B and FS2221B).
8. MOTOR PACKAGE
| MP65B | 6.5MPH 4-Pole Motor Package / with Brake Release | STD |
| MP65-OPT | 6.5MPH 4-Pole Motor Package / with COG Release | CLIENT COST $395 |
| MP85 | 8.5MPH 4-Pole High Speed Motor Package / with COG Release | CLIENT COST $395 |
Not compatible with the narrow base configuration (FS2221B).
Maximum user weight for this option is 250 lb and requires the R-net 120 Amp Expandable Controller (ECR120).
This motor package is only available with the HWD configuration (ATPR3).
9. ASSISTIVE DRIVING PACKAGE
| SMARTT | Smart-Track Assistive Driving Package | $1,420 |
Smart-Track technology provides increased tracking capabilities with enhanced traction and steering precision. This is ideal for those with marginal hand function or switch control.
Requires the R-net PM 120 Amp Expandable Controller (ECR120).
This option requires either the MP65-OPT or MP85 motor package.
Not compatible with the narrow base configuration (FS2221B).
Recommended for non-proportional Drive Controls.
10. BATTERY CHARGER
| BCOB | 8A Offboard Battery Charger | N/C |
11. BATTERY TRAY AND BASE WIDTH
For MWD Configuration
| FS2221B | N2221 - Battery Tray for Group 22 Batteries with a Narrow 21" base width (Total base width = 21") | N/C |
This option is only available with the MWD configuration (ATPM3).
NOT AVAILABLE WITH THE FOLLOWING OPTIONS:
- WC-19 and ISO 7176-19 Occupied Transit Package (WC19-ISO)
- 6.5MPH 4-Pole Motor Package / with COG Release option (MP65-OPT)
- Smart-Track option (SMARTT)
- 8" front casters (FC8PTM and FC8PIM)
- 14" x 4" Extra Wide Cast Wheels, Pneumatic Tires (DW144PT and DW144PI)
For HWD Configuration
| FS22B | Battery Tray for Group 22NF Batteries - (Total base width = 23 3/8") | STD |
| FS2424B | N2424 - Battery Tray for Group 24 Batteries with a Narrow 24" base width (Total base width = 24") | N/C |
For the HWD configuration, the 23 3/8" compact base is not compatible with most of the Center Mount Front Rigging Options due to mechanical conflicts.
The Straight Front Arm option is not available with any of the Center Mount Front Rigging Options due to mechanical conflicts.
The starting angle is reduced from 90° to 85° for some seat configurations when used with the narrow base configuration (FS2424B).
This option is only available with the MWD configuration (ATPM3).
SELECT ONE FRONT CASTER ARM OPTION FOR THE HWD CONFIGURATION:
| FLARED OUT | (STD) |
| STRAIGHT | (OPTIONAL) |
12. BATTERIES - REQUIRES A SELECTION
| BAT22NFGEL | GEL Battery – Group 22NF – 50 Amps (Each) | AADL CONTRACT RFQ |
| BAT24GEL | GEL Battery – Group 24 – 70 Amps (Each) | AADL CONTRACT RFQ |
| BATO | Omission of the batteries | N/C |
14. DRIVE WHEEL
| DW14PT | 14" Cast Wheel Pneumatic Tires | STD |
| DW14PI | 14" Cast Wheel Pneumatic with Foam Filled Tires | N/C |
| DW144PT | 14" x 4" Extra Wide Cast Wheels, Pneumatic Tires | CLIENT COST $200 |
| DW144PI | 14" x 4" Extra Wide Cast Wheels, Pneumatic with Foam Filled Tires | CLIENT COST $595 |
Increases the overall width of the base by 2 ¾".
Not compatible with the narrow base configuration (FS2221B).
| DW12PT | 12 ½" Cast Wheel Pneumatic Tires | N/C |
| DW12PI | 12 ½" Cast Wheel Pneumatic with Foam Filled Tires | N/C |
12 ½" Drive wheels reduce overall seat to floor height by ¾", lowers ground clearance and speed, but increases motor torque.
15. FRONT CASTERS
MWD CONFIGURATION
| FC6S | 6" Solid Casters – (Not available with the 14" x 4" Extra Wide Cast Wheel options DW144PT or DW144PI) | STD |
| FC8PTM | 8" Pneumatic Casters | N/C |
| FC8PIM | 8" Pneumatic Casters with Foam Filled Tires | N/C |
The 8" casters are NOT compatible with the 12 ½" Drive wheel configuration (DW12PT and DW12PI).
Not compatible with the narrow base configuration (FS2221B).
HWD CONFIGURATION
| FC8PTR | 8" Pneumatic Casters | STD |
| FC8PIR | 8" Pneumatic Casters with Foam Filled Tires | N/C |
| FC9PT | 9" Pneumatic Casters | $150 |
| FC9PI | 9" Pneumatic Casters with Foam Filled Tires | $175 |
The 9" casters will increase the minimum seat to floor height by ½" and are NOT compatible with the 12 ½" Drive wheel configuration (DW12PT and DW12PI).
The 9" casters are NOT compatible with many front rigging options. Please see details in the Front Rigging sections.
16. SEAT TO FLOOR HEIGHT (MEASUREMENT TO THE TOP OF SEAT PAN ± ¼")
OPTIONS FOR A REHAB SEAT ONLY - NO POWER SEATING
Seat-to-Floor heights, for seat only, are for MWD. Remove ¼" height for HWD. Seat to Floor Height increases by 1¼" with the SOWN11-16 seat option.
| STFH155 | 15 ½" (Possible Seat angle of 0°) |
| STFH1625 | 16 ¼" (Possible Seat angle of 0°) |
| STFH1725 | 17 ¼" (Possible Seat angle of 0° and 3°) |
| STFH1825 | 18 ¼" (Possible Seat angle of 0° and 3°) |
| STFH1925 | 19 ¼" (Possible Seat angle of 0°, 3° and 6°) |
| STFH2025 | 20 ¼" (Possible Seat angle of 0°, 3°, 6°, 9°) |
Requires the 12 ½" Drive wheels (DW12PT and DW12PI).
OPTIONS FOR A POWER TILT OR A STD POWER ELEVATE MODULE
Seat-to-Floor heights, for seat only, are for MWD. Add ¼" height for HWD. Seat to Floor Height increases by 1¼" with the SOWN11-16 seat option.
| STFH155 | 15 ½" (Possible Seat angle of 0°) |
| STFH1625 | 16 ¼" (Possible Seat angle of 0°) |
| STFH1725 | 17 ¼" (Possible Seat angle of 0° only) |
| STFH1775 | 17 ¾" (Possible Seat angle of 0° only) |
| STFH1825 | 18 ¼" (Possible Seat angle of 0° only) |
| STFH1875 | 18 ¾" (Possible Seat angle of 0° only) |
Requires the 12 ½" Drive wheels (DW12PT and DW12PI).
OPTIONS FOR A COMBO - POWER TILT WITH A STD POWER ELEVATE MODULE
Seat-to-Floor heights, for seat only, are for MWD. Add ¼" height for HWD. Seat to Floor Height increases by 1½" with the SOWN11-16 seat option.
| STFH175 | 17½" (Possible Seat angle of 0° only) |
| STFH1825 | 18 ¼" (Possible Seat angle of 0° only) |
Requires the 12 ½" Drive wheels (DW12PT and DW12PI).
17. SEAT TO FLOOR HEIGHT SPECIFICATION (IF NOT STANDARD)
| SOMHSS | Specific seat to floor height higher than standard. It's not possible to lower the seat to floor height below minimum ranges. | RFQ |
Required at: _________________" (± ¼" Range)
18. PRE-SET SEAT FRAME ANGLE (FOR NON-RECLINING BACKS)
| SFE-0 | 0° Pre-set seat frame seat angle – (Must be selected when using power options) | STD |
| SFE-3 | 3° Pre-set seat frame seat angle – (Only available with a seat configuration without power options) | N/C |
| SFE-6 | 6° Pre-set seat frame seat angle – (Only available with a seat configuration without power options) | N/C |
| SFE-9 | 9° Pre-set seat frame seat angle – (Only available with a seat configuration without power options) | N/C |
19. LIGHTING PACKAGE
| EOLP | LED Light Package – (Includes front and rear lights with integrated flashers) | CLIENT COST $1,425 |
Requires the upgraded Joystick with Light Operation or the OMNI 2 (ECVJ6KL, ECELJL, ECRJCL, ECRJC35B or EDIB).
21. EXPANDABLE ELECTRONICS - PG DRIVES R-NET CONTROLLERS
| ECEL90 | R-net EL 90 Amp Expandable Controller | $175 |
| ECR120 | R-net PM 120 Amp Expandable Controller | $275 |
22. EXPANDABLE ELECTRONICS - PG DRIVES R-NET JOYSTICKS
Selection of one joystick option below is required with the expandable controller ECEL90 or ECR120.
| ECO | Omit Joystick – (For use with an Omni 2 Display) | N/C |
| ECELJ | R-net - (LED) - Joystick | STD |
| ECRJC | R-net Joystick with Color screen | $155 |
JOYSTICKS WITH LIGHTING OPERATION
| ECELJL | R-net - (LED) - Joystick with Lighting Operation | CLIENT COST $125 |
| ECRJCL | R-net Joystick with Color screen and Lighting Operation | $180 |
This joystick is not compatible with the Memory Seat Program Option (SACMEMORY and MACMEMORY).
ADVANCED JOYSTICK
| ECRJC35B | R-net Advanced Bluetooth Joystick (3.5" Screen). Lighting Operation, paddle switches, shortcut keys and stereo jacks | CLIENT COST $1,105 |
23. JOYSTICK MOUNT
| JSMF | Fixed Joystick Mount | N/C |
| JSMSA | Swing Away Joystick Mount - Height adjustable, Angle adjustable and Multi-Axis | $235 |
| JSMCM | Midline Mounted Swing Away Joystick Mount | $275 |
Select:
- Set-up with standard installation to swing-away sideways
- Set-up at 35° to swing-away sideways and downwards
Select:
- Mechanical Lock (STD)
- Magnetic Lock
24. JOYSTICK MOUNT SUPPORT
| JSMFH | Joystick mount support Bracket | STD |
25. JOYSTICK HAND MOUNT
| HML | Install Joystick on Left hand side |
| HMR | Install Joystick on Right hand side |
26. JOYSTICK HANDLE
| JSH | Standard Joystick Gimble | STD |
| JBH | Ball Handle | $130 |
| JTH | T-Handle | $70 |
| JGP | Bodypoint 4" U-shaped Handle | $210 |
| JBAT | Stick Handle 3" in Length | $130 |
| JFBH | Foam Ball Handle | $70 |
| JMUSH | Bodypoint Mushroom Handle | $210 |
29. R-NET OMNI 2 - ENHANCED DISPLAY & DIGITAL INTERFACE BOX (REQUIRED WITH SPECIALTY CONTROLS)
| EDIB | Omni 2 (Enhanced Display & Digital Interface Box with Infrared) | $1,915 |
Allows the switch operation of alternative devices through driver controls. Requires the R-net fully Expandable Controller (ECR120).
The Omni 2 display mount must be selected from the option below.
30. OMNI 2 ENHANCED DISPLAY MOUNT
| EDSAM | User Swing Away Mount | CODE W100 N/C |
31. ENVIRONMENTAL CONTROL MODULE
| ECU | Environment control module - (Output Module) | CLIENT COST $995 |
Requires one of the fully expandable R-net controllers (ECEL90 or ECR120).
Options:
- EDML - (Install Display on LH side)
- EDMR - (Install Display on RH side)
33. AMYSEAT REHAB SEAT / POWER SEATING SYSTEMS AND MODULES
| SAABA | Amyseat Rehab Seat – (Seat Frame only) | $880 |
| SAPTX | CG Power Tilt | CODE W995 $6,195 |
| SAPRX | Power Recline with Mechanical Shear Reduction (MSR) | CODE W995TR $7,845 |
| SAPTPRX | CG Power Tilt and Power Recline with Mechanical Shear Reduction (MSR) | CODE W995TR $11,495 |
| SAPESX | ALTA 11" Power Seat Elevation | CLIENT COST $4,495 |
| ADDPESX | Module - Add ALTA 11" Power Seat Elevation to either SAPTX, SAPRX or SAPTPRX | CLIENT COST $2,495 |
| ADDMR | Module - Manual Recline with Mechanical Shear Reduction - (MSR) | $1,125 |
This option includes the Amyseat Rehab Seat - (SAABA).
This option is not available with the pediatric seat frame SOWN11-16.
The maximum user weight capacity with this option is 250 lb.
34. ELECTRONICS - SINGLE (1 ACTUATOR) POWER SEAT FUNCTION CONTROLLERS
SINGLE SEAT FUNCTION USING AN EXTERNAL TOGGLE OR OPTIONAL SWITCH ONLY (FOR BOTH EXPANDABLE AND NON-EXPANDABLE SYSTEMS)
| SOLO | Single function controller (Includes an external toggle switch) | STD |
OPTIONAL SWITCHES
| SWTOGGLE | Single Toggle Switch | User Activation | Attendant Activation | $100 | |
| SWPUSH1 | Single Push Button Switch - (Single Mode: SAC) | User Activation | Attendant Activation | $90 | |
| SWPUSH2 | Dual Push Button Switch - (Dual Mode: SAC) | User Activation | Attendant Activation | $180 | |
| SSBS | Buddy Button Switch | Black Red Green Yellow | User Activation | Attendant Activation | $230 |
| SSES | Egg Switch-Black | User Activation | Attendant Activation | $116 | |
| SSML | Ultra Light Switch | User Activation | Attendant Activation | $295 |
SINGLE SEAT FUNCTION THROUGH DRIVE CONTROL
| EPSEL | Single Function Through Drive Control with R-net 90-amp controller | N/C |
Allows for activation of single power option through R-net 90-amp controller.
Compatible with all R-net joysticks.
Does not allow for control of power option through drive control and separate switches.
Can not operate more than one power option.
If selecting memory seating, choose SAC below.
If selecting 120-amp R-net controller, choose SAC below.
| SAC | Single Function Through Drive Control with R-net 90-amp or 120-amp controller | N/C |
Allows for activation of single power option through R-net drive controls.
Compatible with 90-amp or 120-amp controller, all R-net joysticks, Omni 2 and specialty controls.
Capable of operating tilt with power seat elevate.
Compatible with memory seating.
SINGLE SEAT FUNCTION OPTIONS (OPTIONS BELOW ARE COMPATIBLE ONLY WHEN CHOOSING SAC ABOVE)
| SACMEMORY | Memory Seat Program | CLIENT COST $1,495 |
This option is not compatible with LED joysticks (ECELJ and ECELJL).
SELECTION OF SWITCH BELOW GIVES ACCESS TO POWER OPTIONS THROUGH DRIVE CONTROLS AND THROUGH EXTERNAL SWITCH
| SACTOGGLE | Single Toggle Switch | User Activation | Attendant Activation | CODE W100 $410 | |
| SACPUSH1 | Single Push Button Switch - (Single Mode: SAC) | User Activation | Attendant Activation | CODE W100 $400 | |
| SACPUSH2 | Dual Push Button Switch - (Dual Mode: SAC) | User Activation | Attendant Activation | CODE W100 $490 | |
| SACSSBS | Buddy Button Switch | Black Red Green Yellow | User Activation | Attendant Activation | CODE W100 $540 |
| SACSSES | Egg Switch-Black | User Activation | Attendant Activation | CODE W100 $426 | |
| SACSSML | Ultra Light Switch | User Activation | Attendant Activation | CODE W100 $605 |
35. ELECTRONICS - MULTIPLE POWER SEAT FUNCTION CONTROLLER
MULTIPLE SEAT FUNCTIONS THROUGH R-NET
| MAC | E-BX Multiple Function through Drive Control with Expandable Electronics - Powers iQ Actuators | $2,295 |
Required with the combined selection of the 90° Power Center Mount Elevating & Articulating Foot Platform (ADDPF) and the narrow base configuration (FS2221B).
MAC OPTIONS
| MACMEMORY | Memory Seat Program | $175 |
SELECTION OF SWITCH BELOW GIVES ACCESS TO POWER OPTIONS THROUGH DRIVE CONTROLS AND THROUGH EXTERNAL SWITCH
| MACKEYPAD-P | Keypad w/ 5 Push Button Switches | User Activation | Attendant Activation | CODE W100 $445 |
| MACKEYPAD-T | Keypad w/ 5 Toggle Switches | User Activation | Attendant Activation | CODE W100 $445 |
| MACMULTI | 4-Way Toggle Switch - (Up to 4 Activations) | User Activation | Attendant Activation | CODE W100 $180 |
| MACMULTIT | Triple Toggle Switch - (Up to 5 Activations) | User Activation | Attendant Activation | CODE W100 $135 |
| MACPUSH4 | 4-Way Push Button Switch | User Activation | Attendant Activation | CODE W100 $225 |
| MACPUSH5 | 5-Way Push Button Switch | User Activation | Attendant Activation | CODE W100 $240 |
By selecting this switch, memory recall is only available through the Joystick.
36. SWITCH ACTIVATION HAND MOUNT
| TSML | (Install Switch on LH side) | |
| TSMR | (Install Switch on RH side) | N/C |
37. PRE-SET BACK ANGLE (FOR NON-RECLINING BACKS)
Select one:
- 86°
- 90°
- 94°
- 98°
- 102°
- 106°
- 110°
- 114°
- 118°
- 122°
Back angles of 102° or greater are not compatible with the OMNI 2.
| SOBAA |
37.5 PEDIATRIC ADJUSTABLE SEAT WIDTH RANGE BETWEEN 11" AND 16"
| SOWN11-16 | Width adjustment from 11" to 16" and Depth range of 11" to 16". Seat to Floor Height increases by 1¼". | N/C |
11" (SOWN11)
12" (SOWN12)
13" (SOWN13)
14" (SOWN14)
15" (SOWN15)
16" (SOWN16)
38. STANDARD ADJUSTABLE SEAT WIDTH RANGE BETWEEN 15" AND 20"
| SOWN15-20-19 | Width adjustment from 15" to 20" with a maximum Depth of 19" | N/C |
15" (SOWN15)
16" (SOWN16)
17" (SOWN17)
18" (SOWN18)
19" (SOWN19S)
20" (SOWN20S)
40. ADJUSTABLE SEAT DEPTH RANGE BETWEEN 11" AND 19"
PEDIATRIC ADJUSTABLE SEAT DEPTH RANGE BETWEEN 11" AND 16"
| 11" (SODN11) | 12" (SODN12) | 13" (SODN13) |
ADJUSTABLE SEAT DEPTH RANGE BETWEEN 15" AND 19"
| 15" (SODN15) | 16" (SODN16) | 17" (SODN17) | 14" (SODN14) | 15" (SODN15) | 16" (SODN16) | N/C |
| 18" (SODN18) | 19" (SODN19) |
41. BACK CANE HEIGHT (THE BACK CANE HEIGHT MEASUREMENT IS TAKEN FROM THE SEAT PAN TO THE TOP OF THE PUSH HANDLES)
| 16" (SOBCH16) | 18" (SOBCH18) | 20" (SOBCH20) | 22" (SOBCH22) | 24" (SOBCH24) | 26" (SOBCH26) |
42. BACK SUPPORT
| DSTR-WWHH | Adjustable Tension Back Upholstery, WW x HH | N/C |
| STDSB-WWHH | Contour back support up to 21" wide, with a maximum shell height of 22". | SEATING BENEFIT $605 |
The minimum space between the back and seat pan is 4" (± 1") with a fixed back and 6" (± 1") with a reclining back.
MATRX BACKS
| E2S-WWHH | MATRX ELITE E2S BACK – (14" to 20" Wide - Back height of 6" to 20", in 2" increments) | SEATING BENEFIT $995 |
| E2D-WWHH | MATRX DEEP CONTOUR ELITE E2D BACK - (14" to 20" Wide - Back height of 6" to 20", in 2" increments) | SEATING BENEFIT $1,155 |
Back shell height is available in 6" to 20", in 2" increments. The minimum space between the back and seat pan is 4" (± 1") with a fixed back and 6" (± 1") with a reclining back.
Weight capacity up to 300 lb.
This product is not compatible with Lateral Trunk Supports.
| PBE-WWHH-TR | MATRX ELITE TR BACK - (15" to 20" Wide - Back height of 14", 16", 18" and 20") | SEATING BENEFIT $910 |
Back shell height is available in 14", 16" 18" or 20". The minimum space between the back and seat pan is 4" (± 1") with a fixed back and 6" (± 1") with a reclining back.
Weight capacity up to 300 lb.
NXT BACKS
| NOACB-WWHH | NXT OPTIMA FH AC CONTOUR BACK - (15" to 21" Wide) | SEATING BENEFIT $690 |
| NOPCB-WWHH | NXT OPTIMA FH PC DEEP CONTOUR BACK – (15" to 21" Wide) | SEATING BENEFIT $790 |
Weight capacity up to 300 lb.
This product is not compatible with Lateral Trunk Supports.
Back shell heights only come in 13", 16" or 19" high. The minimum space between the back and seat pan is 4" (± 1") with a fixed back and 6" (± 1") with a reclining back.
OMISSION OF THE BACK SUPPORT
| STDSBO | Omission of the Contour Back Support | N/C |
Specify Model of Back Support: _____________________________
43. BACK SUPPORT TOTAL HEIGHT (MEASURED FROM THE SEAT PAN TO THE TOP OF THE BACK)
22" is the minimum back height required with a power or manual recline.
| 16" (SOBH16) | 18" (SOBH18) | 20" (SOBH20) | 22" (SOBH22) | 24" (SOBH24) | 26" (SOBH26) |
44. SEAT CUSHIONS (SEATING BENEFIT)
CG AIR - THERAPEUTIC AIR CUSHION
Single Valve 15" to 20" Wide Note: For custom Cushions (Please use the CG Air Order Form)
| Cell Height: | 2" | 3" | 4" |
| CGA1VSCwwdd-h | CG Air Single Valve – (with Standard 2-way Stretch Cover) | SEATING BENEFIT $600 | |
| CGA1V3Dwwdd-h | CG Air Single Valve – (with 3D Mesh Cover) | SEATING BENEFIT $690 | |
| CGA1VICwwdd-h | CG Air Single Valve - (with Incontinence Cover) | SEATING BENEFIT $690 |
Cushion sizes only come in even numbers for width and depth measurements.
Dual Valve 15" to 20" Wide Note: For custom Cushions (Please use the CG Air Order Form)
| Cell Height: | 2" | 3" | 4" |
| CGA2VSCwwdd-h | CG Air Dual Valve – (with Standard 2-way Stretch Cover) | SEATING BENEFIT $600 | |
| CGA2V3Dwwdd-h | CG Air Dual Valve – (with 3D Mesh Cover) | SEATING BENEFIT $690 | |
| CGA2VICwwdd-h | CG Air Dual Valve - (with Incontinence Cover) | SEATING BENEFIT $690 |
Cushion sizes only come in even numbers for width and depth measurements.
CONTOUR SEAT CUSHION
| SCPSC-wwdd | Contour Seat Cushion up to 19" Wide | SEATING BENEFIT $620 |
| SCPSC-wwdd | Contour Seat Cushion for Non-Standard Sizes of 20" to 24" Wide | SEATING BENEFIT $735 |
MATRX CUSHION
| PSP-WWDD | MATRX PSP Seat Cushion - (11" to 20" Wide) | SEATING BENEFIT $645 |
The maximum user weight capacity is 300 lb.
Cushion sizes only come in even numbers for width and depth measurements.
NXT BIO-FIT CUSHION
| NXTBIOFIT-WWDD | NXT BIO FIT Cushion - (15" to 21" Wide) | SEATING BENEFIT $595 |
The maximum user weight capacity is 300 lb.
Cushion sizes only come in even numbers for width and depth measurements.
45. CANTILEVER - HEIGHT ADJUSTABLE ARMRESTS – OPENS WITH A 5° ANGLE (CHOOSE 2)
| SOAFBDLH | Flip-Back Cantilever – Desk Length Left Side – (Height Adjustable from 7" to 15" with 1" increments) | STD Length 12" | N/C | ||
| SOAFBDRH | Flip-Back Cantilever – Desk Length Right Side - (Height Adjustable from 7" to 15" with 1" increments) | STD Length 12" | N/C | ||
| SOAFBFLH | Flip-Back Cantilever - Full Length Left Side - (Height Adjustable from 7" to 15" with 1" increments) – | STD Length 16" | STD | ||
| SOAFBFRH | Flip-Back Cantilever - Full Length Right Side - (Height Adjustable from 7" to 15" with 1" increments) | STD Length 16" | STD | ||
| CUST-112250 | Custom Armrest Length – Select Length for the Left side: | Custom Length 18" | Custom Length 20" | Custom Length 22" | N/C |
| CUST-SOAFB | Custom Armrest Length – Select Length for the Right side: | Custom Length 18" | Custom Length 20" | Custom Length 22" | N/C |
Select this code when using Cantilever armrests with Reclining backs.
The maximum user weight capacity is 300 lb.
46. DUAL POST - HEIGHT ADJUSTABLE ARMRESTS - INCLUDES TRANSFER GRIPS (FOR NON-RECLINING BACKS - CHOOSE 2)
| SOADPPLH | Pediatric Dual Post Height Adjustable – Left Side - (Height Adjustable from 7 ¼" to 10 ¼" with ½" increments) | $168 |
| SOADPPRH | Pediatric Dual Post Height Adjustable – Right Side - (Height Adjustable from 7 ¼" to 10 ¼" with ½" increments) | $168 |
| SOADPDLH | Dual Post Height Adjustable – Desk Length Left Side – (Height Adjustable from 10 ¼" to 15 ¼" with ½" increments) | $168 |
| SOADPDRH | Dual Post Height Adjustable – Desk Length Right Side - (Height Adjustable from 10 ¼" to 15 ¼" with ½" increments) | $168 |
| SOADPFLH | Dual Post Height Adjustable – Full Length Left Side – (Height Adjustable from 10 ¼" to 15 ¼" with ½" increments) | $168 |
| SOADPFRH | Dual Post Height Adjustable – Full Length Right Side – (Height Adjustable from 10 ¼" to 15 ¼" with ½" increments) | $168 |
47. RECLINING FLIP-UP, HEIGHT ADJUSTABLE ARMRESTS (CHOOSE 2)
| SOANIDLH | Reclining armrest – Desk Length Left Side – (Height Adjustable from 10 ½" to 14" with ½" increments) | STD Length 12" | N/C | ||
| SOANIDRH | Reclining armrest – Desk Length Right Side - (Height Adjustable from 10 ½" to 14" with ½" increments) | STD Length 12" | N/C | ||
| SOANIFLH | Reclining armrest – Full Length Left Side - (Height Adjustable from 10 ½" to 14" with ½" increments) | STD Length 16" | N/C | ||
| SOANIFRH | Reclining armrest - Full Length Right Side - (Height Adjustable from 10 ½" to 14" with ½" increments) | STD Length 16" | N/C | ||
| CUST-48247 | Custom Armrest Length – Select Length for the Left side: | Custom Length 18" | Custom Length 20" | Custom Length 22" | N/C |
| CUST-48247 | Custom Armrest Length – Select Length for the Right side: | Custom Length 18" | Custom Length 20" | Custom Length 22" | N/C |
48. ARMREST HEIGHT ADJUSTMENT AT FACTORY
Set the Armrest Height at: _________________ "
The Armrest Height is taken from the seat pan to the top of the armpad.
Not required for Dual Post.
49. ARMPADS
FOAM TYPE SELECTION
| SOWAPD | Desk Length Waterfall - (8 ½" x 2 ¾") | Select side: Left Hand Side | Right Hand Side | STD |
| SOWAPF | Full Length Waterfall - (13" x 2 ¾") | Select side: Left Hand Side | Right Hand Side | STD |
The Waterfall armpads may interfere with flipping back the armrests when combined with Lateral Trunk supports.
HYBRID GEL AND FOAM TYPE SELECTION (THE GEL ALWAYS STAYS SOFT)
| SOGELD | Desk Length Hybrid Gel and Foam Flat armpad – (9 ¾" x 2") | Select side: Left Hand Side | Right Hand Side | SEATING BENEFIT $40 |
| SOGELF | Full Length Hybrid Gel and Foam Flat armpad – (13 ½" x 2") | Select side: Left Hand Side | Right Hand Side | SEATING BENEFIT $40 |
| SOWGELD | Desk Length Hybrid Gel & Foam Waterfall armpad -(8 ½" x 23½") | Select side: Left Hand Side | Right Hand Side | SEATING BENEFIT $95 |
| SOWGELF | Full Length Hybrid Gel and Foam Waterfall armpad - (13" x 23½") | Select side: Left Hand Side | Right Hand Side | SEATING BENEFIT $95 |
The Waterfall armpads may interfere with flipping back the armrests when combined with Lateral Trunk supports.
SPECIALTY TYPE SELECTION
| SOCAR | Arm Trough with Hand Support (18" x 4 ½") | Select side: Left Hand Side | Right Hand Side | $170 |
Arm Trough Armpads may interfere with Armrests Flipping back.
50. FOOTRESTS
| SOPAAF | Signature Pediatric Swing-Away Footrests | Set at: | 60° | 70° | 80° | 90° | STD |
| SOSAAF | Signature Swing-Away Footrests | Set at: | 60° | 70° | SOFLA12 (12 ½" - 17 ½") | SOFLA14 (14 ½" – 19 ½") | STD |
| SOAAF | Signature Heavy Duty Swing-Away Footrests | Set at: | 60° | 70° | SOFLHD12 (12 ½" – 17 ½") | SOFLHD14 (14 ½" – 19 ½") | $175 |
| ADDML | Signature Manual Elevating & Articulating Legrests - Pair | Select Footrest Range: | SOFLME12 (12 ½" - 17 ½") | SOFLME14 (14 ½" – 19 ½") | $595 |
Depending on the seat configuration for both MWD and HWD configurations, the 80° and 90° angles may not be available.
On the HWD version, 70°, 80° and 90° angles are not compatible with the 9" front casters (FC9PT and FC9PI).
70°, 80° and 90° footrest angles may interfere with the casters when selecting the straight front caster arms option.
This option is not available with the pediatric seat frame (SOWN11-16).
On the HWD version, the 70° footrest angle is not compatible with the 9" front casters (FC9PT and FC9PI).
The 70° footrest angle may interfere with the casters when selecting the straight front caster arms option.
This option is not available with the pediatric seat frame (SOWN11-16).
On the HWD version, the 70° footrest angle is not compatible with the 9" front casters (FC9PT and FC9PI).
The 70° footrest angle may interfere with the casters when selecting the straight front caster arms option.
Does not include calf pads. Please select calf pads in section 51.
| ADDPL | Signature Power Elevating & Articulating Legrests | Select Function: Individual | CLIENT COST $2,495 Combined |
Select Footrest Range:
| SOFLPW12 (12 ½" – 17 ½") | SOFLPW14 (14 ½" – 19 ½") |
This option includes calf pads. Individual legs count as two power functions. Combined legs count as one power function.
This option is not available with the pediatric seat frame (SOWN11-16).
51. FOOTPLATES & ACCESSORIES
| SOSFAF | Flip-up Footplates | STD | ||
| SOAFP | Angle Adjustable & Flip-up Footplates – (Each) | $65 | ||
| SOAHL | Heel Loops - (Each) | $20 | ||
| SOACPFR | Calf Pads for Adult Heavy-Duty Swing-Away footrests – (SOAAF) – with adjustable hardware – (Each) | $185 | ||
| SOAMA | Swing-away residual limb Support | Select: Left leg | Right leg | $455 |
52. FOOTREST LENGTH ADJUSTMENT AT FACTORY
Set the Footrest Length at: _________________ "
The Footrest Length is taken from the top of the seat pan to the top of the footplate.
53. CENTER MOUNTS
| SOAAF90 | 90° Fixed Center Mount Interface Bracket - (Offers Manual adjustability from 94° to 70°) | $200 |
Select Foot Platform Range:
| SOFBP7 (8 ½" – 12 ½") | SOFBA12 (12 ½" – 16 ½") |
When selecting SOFBA16 (16 ½" - 19 ½") range, the lowest possible seat to floor height is 18.75" (MWD).
When selecting SOFBA16 (16 ½" - 19 ½") range, the lowest possible seat to floor height is 19" (HWD).
Select the one piece center mount foot platform (SOFUFP) or the split footplates (SOAFPFB).
With the split footplates option (SOAFPFB), this bracket offers independent height adjustability for each footplate.
This option is not compatible with the 9" Caster option on HWD Configuration.
| ADDPF | 90° Power Center Mount Elevating & Articulating Foot Platform | $ 2,495 |
Select Foot Platform Range:
| SOFBPW12 (10 ½"-16") | SOFBPW16 (16"-20") |
When selecting SOFBPW16 (16" - 20") range, the lowest possible seat to floor height is 18.75" (MWD).
When selecting SOFBPW16 (16" - 20") range, the lowest possible seat to floor height is 19" (HWD).
This option includes calf pads. The power center mount counts as one power function.
Select the one piece center mount foot platform (SOFUFP) or the split footplates (SOAFPFB).
This option is not available with the pediatric seat frame (SOWN11-16).
The power center mount option is not available with the straight front caster arms (HWD).
This option is not compatible with the 9" Caster option on HWD.
For the HWD configuration, the 23 3/8" compact frame (FS22B) is not compatible with most of the Center Mount Front Rigging options due to mechanical conflicts.
For leg lengths between 10 ½" and 12 ½", there is a partial conflict where the calf pads prevent the foot platform or foot plates from folding completely.
The starting angle is reduced from 90° to 85° for some seat configurations when used with the narrow base configuration (FS2424B).
The E-BX (MAC) option is required with the combined selection of the 90° Power Center Mount Elevating & Articulating Foot Platform (ADDPF) and the narrow base configuration (FS2424B) on the MWD configuration.
54. FOOT PLATFORMS & ACCESSORIES
| SOFUFP | Flip-up one piece Foot Platform | $140 |
| SOAFPFB | Angle Adjustable & Flip-up Split Footplates for center mount – (Each) | $65 |
| SOACPCM | Calf Pads for 90° Fixed Center Mount – (SOAAF90) with adjustable hardware - (Each) | $93 |
55. FOOT PLATFORM HEIGHT ADJUSTMENT AT FACTORY
Set the Foot Platform Height at: _________________ "
The Foot Platform Height is taken from the top of the seat pan to the top of the foot platform or split foot plates.
56. SEAT POSITIONING (NOT COMPATIBLE WITH THE WC19-ISO OPTION)
| SOAUTO | 55" Seat Positioning Strap | STD |
| SOBPHP2C | Bodypoint padded Hip Belt (Two Point - Center Pull) | $170 |
| SOPHB | Padded Hip Belt, 2-PT Magnetic Center Pull | $194 |
| SOBPCS | Bodypoint padded Chest Strap | $250 |
| SOPCS | Padded Chest Strap, 2-PT Magnetic Center Pull | $262 |
57. HEADREST
Select one of the headrest options with the mounting hardware and specify where the headrest will be installed.
Using headrest mounting hardware other than SOMAH located bellow. Specify: _____________________________
| SONUAHR | Small Curved Headrest Pad - 4" x 9" | N/C |
| SOFHRS | Small Curved Headrest Pad - 4" x 9" | $155 |
| SOFHRM | Medium Curved Headrest Pad - 5" x 10" | $155 |
| SOFHRL | Large Curved Headrest Pad - 6" x 11" | $155 |
| SOMAH | Multi-axis Removable Mounting Hardware | $220 |
| SOHRBC | Bracket to Mount on the Contour Back Support (Without Recline) | N/C |
| SOHRPR | Bracket to Mount on the Seat Frame (For Reclining Backs) | N/C |
58. LATERAL TRUNK SUPPORTS
Select one of the lateral pads and the adjustable & removable hardware.
| SOSLS3 | Adjustable Laterals with Small Curved Pads – (Each) – 3" x 5" | SEATING BENEFIT $100 |
| SOSLM4 | Adjustable Laterals with Medium Curved Pads – (Each) – 4" x 6" | SEATING BENEFIT $100 |
| SOSLL5 | Adjustable Laterals with Large Curved Pads – (Each) – 5" x 7" | SEATING BENEFIT $100 |
| SOSLHM | Adjustable Swing-Away Hardware Mounts - (Each) | SEATING BENEFIT $220 |
Waterfall armpads may interfere with flipping back the armrests when combined with Lateral Trunk supports.
59. HIP & THIGH SUPPORTS
Select one of the hip & thigh support pads and the adjustable & removable hardware.
| SOHTSS10 | Adjustable Hip & Thigh Support Pads – (Each) – Small 10" x 4" | SEATING BENEFIT $130 |
| SOHTSM12 | Adjustable Hip & Thigh Support Pads – (Each) – Medium 12" x 5" | SEATING BENEFIT $130 |
| SOHTSL14 | Adjustable Hip & Thigh Support Pads – (Each) – Large 14" x 6" | SEATING BENEFIT $130 |
| SOHTSARH | Adjustable and Removable Hip & Thigh Support Hardware - (Each) | SEATING BENEFIT $136 |
60. ACCESSORIES
| SOCH | Cup Holder - (Self-Leveling) | Install on: Left Side | Right Side | $115 |
| SOCPH | Ram Mounts X-Grip Cell Phone Holder | Install on: Left Side | Right Side | $190 |
| SOTHS | Ram Mounts X-Grip Small Tablet Holder | Install on: Left Side | Right Side | $205 |
| SOTHL | Ram Mounts X-Grip Large Tablet Holder with Swivel | Install on: Left Side | Right Side | $360 |
Standard installation is on the opposite side of joystick. Installing accessories on the same side as the joystick may require a custom upgrade.
With multiple accessories installed on the same side, a custom upgrade will be required.
61. REFLECTOR KIT
| REFLECT | Red & White Reflector Kit Stickers (They will not be installed – Included in a bag with the Owner's Manual) | N/C |
62. BACK PACK AND ARMREST SIDE POUCHES
| SOBP | Back Pack (Comes with durable straps that can be hooked around the back canes) | CLIENT COST $90 | ||
| SOAP | Armrest Side Pouch - (Comes with durable straps that can be hooked around the armrest tubes) Order: | Left Side | Right Side | CLIENT COST $53 |
If only choosing one (1) armrest pouch, please show what side it should be installed.
63. SWITCHES AND OPTIONS
| ASCPWIFI | PGDT - Wireless programmer, WIFI dongle | NOT COVERED BY AADL $844 |
| ASCPCP | PGDT R-NET Dongle and PC programmer kit | NOT COVERED BY AADL $600 |
| SSBS | Buddy Button Switch | $230 |
| SSES | Egg Switch-Black | $116 |
| SSML | Ultra Light Switch | $295 |
| ESS-RED | Emergency STOP Switch - Red | $314 |
SPECIALTY DRIVER CONTROL OPTIONS
Specialty Drive Control options all require the Omni 2 Enhanced Display & Digital Interface Box (EDIB).
64. THERAFIN SIP-N-PUFF KIT (CODE W100)
| SCSNPK | Therafin Sip-N-Puff Kit | $1,975 | ||
| SCSNPBTK | Therafin Sip-N-Puff Breath Tube Kit | N/C | ||
| SCSRMSNP | Stealth Rock-n-Lock Swingaway Arm for Sip-N-Puff | SWL (Swings on Left) | SWR (Swings on Right) | $300 |
| SCSRM | Stealth Rock-n-Lock Swingaway Mount for Mode Switch | SWL (Swings on Left) | SWR (Swings on Right) | $510 |
| SSES | Egg Switch for Changing Modes – Black | MLH (Mount on Left) | MRH (Mount on Right) | $116 |
| ESS-RED | Emergency STOP Switch - Red | User Activation | Attendant Activation | $314 |
| SOMAH | Multi-axis Headrest Removable Mounting Hardware | $220 |
Required with the Therafin Sip-N-Puff kit.
Required with the Stealth Rock-n-Lock Swing Away mount.
The Mode Switch Type can be changed from this selection in SWITCHES & OPTIONS section.
CHOOSE ONE (1) HEADREST PAD
| SOFHRS | Small Curved Headrest Pad - 4" x 9" | $155 |
| SOFHRM | Medium Curved Headrest Pad - 5" x 10" | $155 |
| SOFHRL | Large Curved Headrest Pad – 6" x 11" | $155 |
65. PROXIMITY HEAD ARRAY (CODE W100)
| SCSIHAP | Pediatric - Switch-It 3 Switch Proximity Head Array with 1/8" Mono Jack for mode/reverse | $5,995 | ||
| SCSRM | Stealth Rock-n-Lock Swingaway Mount for Mode Switch | SWL (Swings on Left) | SWR (Swings on Right) | $510 |
| SSES | Egg Switch for Changing Modes – Black | MLH (Mount on Left) | MRH (Mount on Right) | $116 |
| ESS-RED | Emergency STOP Switch - Red | User Activation | Attendant Activation | $314 |
| SOMAH | Multi-axis Headrest Removable Mounting Hardware | $220 |
Required with the Proximity Head Array.
Required with the Stealth Rock-n-Lock Swing Away mount.
The Mode Switch Type can be changed from this selection in SWITCHES & OPTIONS section.
66. LIGHT TOUCH PROPORTIONAL MINI JOYSTICK FOR CHIN / LIP CONTROL (CODE W100)
| SCSIMP | Switch-It Light touch mini Proportional Joystick | SWL (Swings on Left) | SWR (Swings on Right) | $4,495 |
| SCSRMMP | Stealth Rock-n-Lock Swingaway Arm for Chin MP | SWL (Swings on Left) | SWR (Swings on Right) | $870 |
| SCSRM | Stealth Rock-n-Lock Swingaway Mount for Mode Switch | SWL (Swings on Left) | SWR (Swings on Right) | $510 |
| SSES | Egg Switch for Changing Modes – Black | MLH (Mount on Left) | MRH (Mount on Right) | $116 |
| JCC | Chin Cup | $55 | ||
| SOMAH | Multi-axis Headrest Removable Mounting Hardware | $220 |
Required with the Light touch mini Proportional Joystick.
Required with the Stealth Rock-n-Lock Swing Away mount.
The Mode Switch Type can be changed from this selection in SWITCHES & OPTIONS section.
CHOOSE ONE (1) HEADREST PAD
| SOFHRS | Small Curved Headrest Pad - 4" x 9" | $155 |
| SOFHRM | Medium Curved Headrest Pad - 5" x 10" | $155 |
| SOFHRL | Large Curved Headrest Pad - 6" x 11" | $155 |
67. PROPORTIONAL COMPACT OR MINI JOYSTICK FOR MIDLINE MOUNT (CODE W100)
| SCPGMJS | PG Drives JC200 Proportional Compact Remote Joystick for Midline Mount | MLH (Mount on Left) | MRH (Mount on Right) | $2,369 |
| SCGMJSM | Gatlin Midline Swing-away Mount for JC200 | MLH (Mount on Left) | MRH (Mount on Right) | $325 |
| SCSIMP | Switch-It Light touch mini Proportional Joystick | MLH (Mount on Left) | MRH (Mount on Right) | $4,495 |
| SCGMPM | Gatlin Midline Swing-away Mount for Light touch mini proportional Joystick | MLH (Mount on Left) | MRH (Mount on Right) | $750 |
| SCBTM | Bullet Hand Tray for Light Touch mini Proportional Joystick | MLH (Mount on Left) | MRH (Mount on Right) | $750 |
Must be selected for use with the PG Drives JC200 Mini Joystick.
Must be selected for use with the Light touch mini Proportional Joystick.
This option is only compatible with the Light touch Mini Proportional Joystick.
68. PROPORTIONAL COMPACT OR MINI JOYSTICK FOR ARMREST MOUNT (CODE W100)
| SCPGMJS-M | PG Drives JC200 Proportional Compact Remote Joystick for Armrest Mount | MLH (Mount on Left) | MRH (Mount on Right) | $2,369 |
| SCARMJSM | Swing-away and Multi-Axis armrest mount | MLH (Mount on Left) | MRH (Mount on Right) | $325 |
| SCSIMP | Switch-It Light touch mini Proportional Joystick | MLH (Mount on Left) | MRH (Mount on Right) | $4,495 |
| SCARMPM | Swing-away and Multi-Axis armrest mount | MLH (Mount on Left) | MRH (Mount on Right) | $375 |
| SCBTM | Bullet Hand Tray for Light Touch mini Proportional Joystick | MLH (Mount on Left) | MRH (Mount on Right) | $750 |
Must be selected for use with the PG Drives JC200 Mini Joystick.
Must be selected for use with the Light touch mini Proportional Joystick.
This option is only compatible with the Light touch Mini Proportional Joystick.
69. PROPORTIONAL RIM HEAD CONTROL PACKAGE (CODE W100)
| SCPHC | Proportional RIM Head Control Package | $2,795 | ||
| SCSRM | Stealth Rock-n-Lock Swingaway Mount for Mode Switch | SWL (Swings on Left) | SWR (Swings on Right) | $510 |
| SSES | Egg Switch for Changing Modes – Black | MLH (Mount on Left) | MRH (Mount on Right) | $116 |
| SOMAH | Multi-axis Headrest Removable Mounting Hardware | $220 |
Required with the Stealth Rock-n-Lock Swing Away mount.
The Mode Switch Type can be changed from this selection in SWITCHES & OPTIONS section.
Required with the Proportional RIM Head Control.
CUSTOM SECTION
Lead times will increase depending on the custom order pipeline at the time the purchase order is received. Please call for Quote and specifications for these options.
70. O2 HOLDER
| SUPOXY | Custom Non-Articulating Oxygen Tank Holder | MLH (Mount on Left) | MRH (Mount on Right) | $295 |
| SUPOXYA | Custom Articulating Oxygen Tank Holder | MLH (Mount on Left) | MRH (Mount on Right) | $1,195 |
Not available with a power recline.
Required with a power recline.
D-Size Oxygen Tank - (* 22" Tall x 4.3" Diameter) – * The height includes the valve
E-Size Oxygen Tank – (* 31" Tall x 4.3" Diameter) – * The height includes the valve
71. VENT TRAY (PLEASE COMPLETE IN FULL)
Amylior does not supply the battery, charger or the wiring for the Vent. These items are normally provided by the Vent Manufacturer.
| SOVENT | Custom Vent Tray | $1,360 |
| Articulating Vent Box (Required with Power Tilt and/or Recline) | $400 | |
| Fixed Vent Box |
SPECIFY MODEL
- Trilogy 100/200
- LTV
- LTV with Sprintpack
- Other, specify: _____________________________________________________________
| SOVTBE | Extended Battery Compartment | $495 |
The Vent Tray option is not available on narrow options N2424 & N2221 (FS2424B & FS2221B).
The Vent is being powered by 1 U1 Battery and the chair by 2 Group 22NF batteries.
The Vent is being powered by 1 U1 Battery and the chair by 2 Group 24 batteries.
The Vent is being powered by 1 Group 22NF Battery and the chair Powered by 2 Group 22NF Batteries.
The Vent is being powered by 1 Group 24 Battery and the chair Powered by 2 Group 22NF Batteries.
The Vent is being powered by 1 Group 22NF Battery and the chair Powered by 2 Group 24 batteries.
72. OTHER CUSTOM OPTIONS (REQUEST FOR QUOTE)
Please specify details and specifications for these options.
| CUSTOM | Lithium ion - 54 Amps (represents one 24V Battery pack, equivalent to two Group 22 Batteries) | CLIENT COST RFQ | |||
| CUSTOM | 8A Offboard Battery Charger for Lithium ion batteries | CLIENT COST N/C | |||
| CUSTOM | Lithium ion Battery capacity LCD display gauge | CLIENT COST N/C | |||
| CUSTOM | Rear view Camera with 5" Monitor | CLIENT COST RFQ | |||
| CUSTOM | USB Charger Port | Specify the location for the installation: _____________________________ | CLIENT COST RFQ | ||
| CUSTOM | Folding Backrest for Additional Storage possibilities and Travel accessibility | CLIENT COST RFQ | |||
| CUSTOM | Large Ball Handle | CLIENT COST RFQ | |||
| CUSTOM | Manual Wheel Locks (MWD ONLY) | CLIENT COST RFQ | |||
| CUSTOM | Power Anterior Tilt | CLIENT COST RFQ | |||
| CUSTOM | Power Lateral Tilt 15° | Raise the Left Side only | Raise the Right Side only | Raise the Left & Right Side | CLIENT COST RFQ |
| CUSTOM | Power Latitude System - (Features 14" of forward travel and a 5" seat to floor height from the pan to the ground) | CLIENT COST RFQ | |||
| CUSTOM | Power Elevating Stretcher - (Please call CSR for availability with configuration and user weight capacity) | CLIENT COST RFQ | |||
| CUSTOM | Rearview mirror | Left Side | Right Side | ||
| CUSTOM | Power Flip-up Foot Platform - (Please call CSR for availability with configuration and user weight capacity) | CLIENT COST RFQ | |||
| CUSTOM | Power Vertical Lifting Foot Platform - (Please call CSR for availability with configuration and user weight capacity) | CLIENT COST RFQ | |||
| CUSTOM | Independent Depth Adjustability built into the Footrest Receiver that is attached to the Seat Pan | CLIENT COST RFQ | |||
| CUSTOM | Heavy-Duty wheelchair cover, Large | CLIENT COST RFQ | |||
| CUSTOM | Endomorphic Back Canes – (Pair) | 1" per side towards the inside = 2" | 2" per side towards the inside = 4" | CLIENT COST RFQ | |
| CUSTOM | Transfer Handles - (Pair) | Select a height range: 5" to 8" | 6" to 9" | CLIENT COST RFQ | |
| CUSTOM | Foot Box Length: ______________ Width: _______________ Please confirm with CSR on sizing possibilities | CLIENT COST RFQ | |||
| CUSTOM #1 | Other custom options. Specify in notes section below | CLIENT COST RFQ | |||
| CUSTOM #2 | Other custom options. Specify in notes section below | CLIENT COST RFQ |
This option is required when choosing custom Lithium ion batteries.
This option is required when choosing custom Lithium ion batteries.
This option is not available on HWD.
This option is not available with the Straight Front Caster Arms on HWD.
This option is not available with the Straight Front Caster Arms on HWD.
This option is not available with the Straight Front Caster Arms on HWD.
73. NOTES / SPECIAL REQUESTS / CUSTOM SPECIFICATIONS
Please use this section for any additional notes, special requests, or custom specifications not covered elsewhere in this form.
