Freedom Designs, Inc. Adult Manual Wheelchair Transport Package

Transcript

Adult Manual Wheelchair Transport Package Optional Freedom Designs, Inc. 2241 N. Madera Road Simi Valley, CA 93065 Phone: (800) 331-8551 Company:___________________________________ Buyer:______________________________________ Marked For:__________________________________ Description Part No. Address:____________________________________ City:__________________State:_____ Zip:________ Phone:______________________________________ Retail Description Part No. Frame Type TriPod LT (Rigid) (K0005) www.freedomdesigns.com Company:___________________________________ Ship to: Bill to: Date:_____________ PO#:_____________________ Fax (888) 582-1509 Frame Length LATP-30270 $2315 Specify Frame Length: Small Front Frame Configuration 90 Degree Straight LATP-30330 n/c   Transport Option Transport Package LATP-99999 (11” - 13”) Set-up Depth:  11” Deep  12” Deep  13” Deep LATP-30507 n/c LATP-11 LATP-12 LATP-13 n/c n/c n/c Medium (12” - 15”) LATP-30508 n/c Set-up Depth: 12” Deep  13” Deep 14” Deep  15” Deep LATP-12 LATP-13 LATP-14 LATP-15 n/c n/c n/c n/c Long LATP-30510 n/c LATP-15 LATP-16 LATP-17 LATP-18 n/c n/c n/c n/c (15” - 18”) $150 Available with FDI WC19 approved seating or on frame only. No Transport Package Retail LATP-99999-1 Set-up Depth: 15” Deep  16” Deep n/c  17” Deep  18” Deep Frame & Axle Colors—Powder Coated Shorter seat depth may be achieved through seating system. Seat depth indicates back cane placement.  Black  Neon Yellow  Bright Pink  Octane Orange  Blizzard Blue  Pacific Blue  Blue Blast  Passion Purple Omit Seat Pan or Sling LATP-39011 n/c  Candy Violet  Pink Parfait  Candy Raspberry  Really Red Seat Pan - Fixed Seat Pan w/EZ Lite LATP-39010 LATP-39013 $100 $150  Vigorous Violet  Red Sunset Seat Sling LATP-39012 n/c  Extreme Green  Sparkle Green Specify Sling Length:  Galaxy Blue  Twilight Front of seat rail to back upholstery.  Sugar Plum  Yellow  Mystic Teal LATP-30501 LATP-30502 LATP-30503 LATP-30504 LATP-30505 LATP-30506 LATP-30537 LATP-30538 n/c n/c n/c n/c n/c n/c n/c n/c  Axle Colors Black Yellow Same as Frame Frame Width Specify Frame Width: 12” Wide 14” Wide 16” Wide 18” Wide LATP-30220 LATP-30240 LATP-30260 LATP-30280 Seating Options  Seat Sling Length:       11” 12” 13” 14” 15” 16” 17”  18” Deep Deep Deep Deep Deep Deep Deep Deep n/c n/c n/c 1” Cushion n/c 2” Cushion Cushions LATP-39003 LATP-39007 $ 85 $ 95 Includes 4# foam & black knit cover. Page 1 of 4 Adult TriPod LT 10/23/13 2241 N. Madera Road Simi Valley, CA 93065 Phone: (800) 331-8551 Fax (888) 582-1509 www.freedomdesigns.com Date:______________ PO#:_______________________ Marked For:_____________________________________ Description Description Part No. Retail LATP-30600 n/c  Angle Adjustable, Flip-Up Footboard (K0040) Specify height from rear seat rail to top of straight cane: High High High High High High LATP-30610 LATP-30611 LATP-30612 LATP-30613 LATP-30614 LATP-30615 3/4” Telescoping Push Handles LATP-30616 n/c Individual Flip Up/Angle Adjustable n/c Footplates (K0040) n/c n/c Composite Individual Flip Up Footplates n/c n/c Adjustable leg length from 4.5” - 6.5”. LATP-30518 n/c Ergo Bend Push Handles    Traditional  LATP-30519 n/c Push Handle $125 LATP-36030 $105 LATP-36031 n/c All measurements are without cushions. $175 (10" - 16") These are push handles only. Back upholstery does not attach to telescoping handles. For use with straight back posts only. Traditional Bend Push Handles LATP-36028 Adjustable leg length from 3 1/2” - 12”. Flip up footboard available with straight (non taper) frames only. With fold over sling back 10”  11” 12”  13” 14”  15” Retail Footrest Options Back Posts / Push Handles Hand Grip Bend Options Straight - No push handles Part No. Angle Adjustable Flip Up Footplate Ergo Push Handle Flip Up Footboard Specify height from rear seat rail to top of bend on cane: Short (19” High) Medium (23” High) Tall (26” High) LATP-30515 LATP-30514 LATP-30516 n/c n/c n/c Push Handle Extension LATP-30517 $100  Knee to Heel Measurement __________ Inches Casters Quick Release 1 Piece Push Handle Ext. LATP-30526 $125 Available on chairs 14”W and up.      Back canes can achieve an additional height of 6.5” when either quick release push handle extensions are ordered. Omit Casters Wheels LATP-34333 n/c  3” Poly Casters 3” Light Up Casters LATP-34888 LATP-34111 $ 55 $ 55 4” Poly Casters 4” Light Up Casters LATP-40000 LATP-41000 $ 65 $ 99 5” Poly Casters 5” x 1.5” Poly Casters LATP-34555 LATP-34222 n/c $ 65 6” Poly Casters 6” x 1.5” Poly Casters 6” Pheumatic Casters LATP-34666 LATP-34999 LATP-34667 n/c $ 85 $ 75 Quick Release One Piece Push Button Angle LATP-30527 $175 Adjustable Stroller Handle Sling Backs Omit Sling Back Sling Back Tension Adjustable Back LATP-39005 LATP-39015 LATP-30008 n/c n/c $231 Back upholstery height must be chosen when ordering sling or tension adjustable back upholstery. Specify Sling Back Height: Top of seat to top of back upholstery. 10” High LATP-30910 LATP-30911 LATP-30912 LATP-30913 LATP-30914 LATP-30915 LATP-30916 LATP-30917 LATP-30918 11” High 12” High 13” High 14” High 15” High 16” High 17” High 18” High Page 2 of 4 Adult TriPod LT n/c n/c n/c n/c n/c n/c n/c n/c n/c 10/23/13   0 Degrees  3 Degrees  6 Degrees Center Wheel Camber Angle LATP-31010 LATP-31011 LATP-31012 n/c n/c n/c 2241 N. Madera Road Simi Valley, CA 93065 Phone: (800) 331-8551 Fax (888) 582-1509 www.freedomdesigns.com Date:______________ PO#:_______________________ Marked For:_____________________________________ Description Description Part No. Retail Part No. Retail Wheel Locks Rear Wheels & Wheel Accessories Patented double lock axle receiver included at no charge. Omit Wheels & Axles LATP-31524 ($55) Specify lever type:  Push to Lock Pull to Lock Wheel Lock Handle Ext. (E0961)   LATP-31501 LATP-31506 LATP-31801 n/c n/c $ 60 Armrests—Back Cane Mount Mag Wheels 20” Pneumatic Mag Omit Flip Back Armrest LATP-38209 ($20) Back Cane Mount  Flip Back Armrest—13" Long Flip Back Armrest—16” Long LATP-38204 LATP-38202 n/c n/c LATP-31527 n/c 22” Pneumatic Mag LATP-31528 n/c Locking Flip Back Armrest— LATP-38201 $235 24” Pneumatic Mag LATP-31529 n/c 13” Long (E0973) Locking Flip Back Armrest— 16” Long (E0973) LATP-38200 $235  Flip Back Armrests—Telescoping  Locking Flip Back Armrests— LATP-38208 LATP-38207 $100 $260 LATP-38203 $235 Only available with 3” casters. Aluminum handrims are standard on 20”, 22” & 24” wheels. To omit handrims, please check below. 24” wheels are not available with small frame small lengths. Telescoping         Frame Mount Height Adjustable Padded Armrests (E0973) Not available with sling or seat pan. Spoke Wheels 20” Pneumatic Spoke LATP-31540 $200 22” Pneumatic Spoke LATP-31541 $200 24” Pneumatic Spoke LATP-31542 $200 Only available with 3” casters. Locking Flip Back Armrest Flip Back Armrest Aluminum handrims are included on 20”, 22” & 24” wheels.   To omit handrims, please check below. Desk Length Flat Armrest Pad LATP-38213 n/c Plastic coated handrims are not available with spoke wheels. Full Length Flat Armrest Pad LATP-38214 n/c Height Adjustable Padded Armrest Only available on 16” armrests. 24” wheels are not available with small frame lengths. Seat Rail to Top of Armrest ___________Inches Wheel Accessories Omit Handrims LATP-31006 ($15) Plastic Coated Handrims (pr.) LATP-31005 $117 Plastic coated handrims are not available with spoke wheels Natural Fit Handrims Please contact your customer service representative for details. Airless Inserts (pr.) (E2213) LATP-31000 $ 75 For pneumatic tires only. Page 3 of 4 Adult TriPod LT 10/23/13 2241 N. Madera Road Simi Valley, CA 93065 Phone: (800) 331-8551 Fax (888) 582-1509 www.freedomdesigns.com Date:______________ PO#:_______________________ Marked For:_____________________________________ Description Description Part No. Retail Accessories Part No. Retail Wheel & Caster Matrix Wheel Size Caster Size Floor to Front of Seat Rail Arc Over Rail 20” 4” 14.75” 7” $120 22” 4” 15.75” 7” LATP-CGR $120 24” 4” 16” 8” LATP-SG $ 90 20” 5” 16.25” 7” 22” 5” 17.25” 7” 24” 5” 17.5” 8” 20” 6” 16.5” 7” 22” 6” 17.75” 7” 24” 6” 18” 8” Medical Necessities Bag LATP-23207 $ 67 Back Pack (black only) LATP-TFBP $ 55 Clothing Guards (fabric) LATP-CGF Clothing Guards (Quick Release - rigid) Spoke Guards Maximum Rider Weight—200 lbs. Frame weight approximately 16.5 lbs. Notes: Notes:   Page 4 of 4 Adult TriPod LT 10/23/13