quickie qx aadl - w113customer service: (800) 263-3390 fax: (800) 561-5834 e-mail:...
TRANSCRIPT
Customer Service: (800) 263-3390 Fax: (800) 561-5834 E-mail: [email protected] www.sunrisemedical.ca Specifications are subject to change without notice. © 2019 Sunrise Medical Canada Inc. MK-100379-CAN REV (1).
Page 1 of 5
EIF6, November 2019
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PV: PC:( ) Fax: ( )
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See Seat Height Matrix on page 2o
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o Frame Depths equals Seat Depths.o o
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A1 is client responsibility. A2 is clinical justification.
B4ME - 22" Width $284.00
196W11
14"
Standard Frame
Quickie QX, Ultra Lightweight Folding Wheelchair
NC18"
NC15"
196FS9
Seat Depth
196W60
Standard Seat SlingOmit Seat Sling
NC196SD7
Quickie QX featuring the Jay X2™ cushion
16"17"18"
196SD10NCNC
NCNCNC
196SD11
19"
196W9
196SD9
196W10
Not available with EXO standard or Tension adjustable upholstery, Not available with Ballistic Nylon or 3DX Tension adjustable upholstery.
17"
20" NC
196W6
NC
Hemi Frame
Frame Width
Frame Style
2. SIZE / SEATING
NC
Dealer Contact:
Option #
Ship To City:
o
Quickie QXAADL - W113
Dealer Acct #:
Mark For:Date:
Quote
Address:Dealer City:Dealer Phone:
Confirmation E-mail:
Attention:
Order
Ship To:
PO#:
ADDITIONAL SHIPPING INFORMATION
Submitting for:
Dealer Address:
Dealer:
$1,299.00
Confirm Via:
Definition
1. FRAME
Base Model
NC
15"
Quickie QX (Fixed Axle) 300 lbs.
Address:
196SD71
Definition Price Option #
Ship To Phone:Fax
Price
196SL6196SL1 NC
($21.00)
$284.00
NC
196W59 B4ME - 21" Width
Frame Width - Built 4 Me Options
NC
20"
NC
16"
Seat Sling
196SD8196W7
196SD13
196FS30
NC
NC196W8
19"
Base Model196TO38 Transit System WC19
196WM94
196W5 14"
Customer Service: (800) 263-3390 Fax: (800) 561-5834 E-mail: [email protected] www.sunrisemedical.ca Specifications are subject to change without notice. © 2019 Sunrise Medical Canada Inc. MK-100379-CAN REV (1).
Page 2 of 5
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12.5" & 13" only available w/ Alum Angle Adj Footplate o
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See Rear Seat Height Matrix. 12.5" & 18.5" RSH not available with fixed axle. See Rear Tire & Wheel Matrix for availabilityo
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o Natural Fit only available w/ 22, 24, 25 Lite Spoke. Plastic N/A w/ 25, 26"o o
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See Rear Tire & Wheel Matrix for availabilityo
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A1 is client responsibility. A2 is clinical justification.
16.0"
Aluminum Anodized
Front Seat Height
12.5"
Handrim
196SH14
13.5"
196SH2115.5"196SH23
5" Low Profile Polyurethane
196RW1
196CW32
22" Mag Wheel 5 Spoke (Xcore)196RW104 NC
NC
15" NC
NC
NC
Rear Wheel Size
196RH15
196RW3
196RW25
20" Mag Wheel NC
A1
196HR1
High-Pressure Clincher Black
196CS9
196RT39
196SH42 196SH18
NC
196RH17 NC
196SH41 196SH17
196SH35196SH40 Front Seat Height Matrix
14.0"
NC
196SH15
24" Mag Wheel NC
($44.00)
NC
Seat Squeeze Matrix19"
22" Mag Wheel
Omit
196RH26
15.5"
17.5"
16" 196RH18
Rear Seat Height
13"
196CF71
NC
16.5"
196RH16
196RH9
4. REAR WHEELS / REAR SEAT HEIGHTS
18" 196HR4
NC
NC196RH20
196RH19 17"
196CW7
196CF23
14.5"
NCNC
$95.00NC
NC
14.5"
196RW8
Rear Seat Height Matrix
NC196RH21
NC
Pneumatic w/ Airless Insert
NC
A1
$96.00o
Caster Wheels
NC
196CF12
19.0"
6" Polyurethane
NCPneumatic
17.0"
18.0"
196SH16
18.5"
6" x 1.5" Semi Pneumatic NC
Caster Fork
5.25"
7"
196CW39
196CW35
$95.00
8" Polyurethane
NC
NC
$134.00
13.5"
12" 196RT1
196RT3 Full Poly
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196RT2
196RH11NC
196RH14
196RH1214"
3/4"
196RH13
NC
17.5"
NC
$228.00
3. CASTERS / SEAT HEIGHT
NC196CS5
StandardCaster Stem Bolt
196CS1
$134.00Plastic
15.0"
8" x 1.5" Semi Pneumatic
Rear Wheel Tire
3.5" (standard stem bolt only)
20" Mag Wheel 5 Spoke (Xcore)
196CW34
196CW5
4" Low Profile Polyurethane
196SH12196SH13
196CW34" x 1.25" Semi Pneumatic 196CW44
196SH20
19.5"
196CF17 6"
196RW103
13.0" 16.5"
5" x 1.5" Semi Pneumatic
196SH34NC
See Front Seat Height Matrix. 12.5 & 13.0 only available w/ 60° hanger
1 1/2"
NC
196RW102 24" Mag Wheel 5 Spoke (Xcore) NC
Frame Depth Max Seat Squeeze14" 2.0"
15" - 16" 2.5"17" - 18" 2.5"19" - 20" 3.0"
Customer Service: (800) 263-3390 Fax: (800) 561-5834 E-mail: [email protected] www.sunrisemedical.ca Specifications are subject to change without notice. © 2019 Sunrise Medical Canada Inc. MK-100379-CAN REV (1).
Page 3 of 5
Right Hand Mount Left Hand Mount
Ext. handles only available with high mount push or pull wheel locks
Footplate mounts with Extension Tube using clamping hardware See Lower Leg Length Matrix for range
Heel loop not included, see Footplate Option section below
AluminumOnly available w/Elevating Legrest
Adjustable Heel LoopGel Cover For Hangers (Pair)
Integral Push Handles, Folding Height Adjustable & Omit 8° for Std Backrest, Straight for Angle Adj. Backrest
A1 is client responsibility. A2 is clinical justification.
196F271
196B9
80° Swing In/Out Hanger
Omit Wheel Lock
Omit Hanger & Footplate
Articulating Hanger N/A w/ Alum Angle Adj Front Mount footplates.
196H144
A2
A2
A2
NC
196H160
196PH17
Unilateral Wheel Lock Right $295.00
196HM2 A2
$150.00196HL12
NC
Fold-Down Push Handles Only available with Adjustable Upholstery. Used in combination w/Angle Adjust only avail in 16"-20" back height
196PH2 Omit Push Handles NC
$156.00196PH5
Aluminum Angle Adj. Footplate
1968A02
196PH6 Integral Push Handles
196F3
A2
A1
Composite Angle Adj (16"-22"w)
Hanger & Footplate Options
A1
A1
Wheel Lock
196WL2
196H159
Unilateral Wheel Lock Left196WL23
$485.00
Rear Tire & Wheel Matrix
196WL30
NC60° Swing In/Out Hanger
196WL10
70° Swing In/Out Hanger
196WL12
196H145
$313.00
NC
196F1
196H139
High Mount Push
NC
$150.00
NC
NCNC
Available only with 24" MBL Lite spoke wheels. Std Aluminum black handrim. 1AD option is only available on 14" - 19" frame widths.
$138.00
196AX11 $168.00
Extension Tubes
196E2
196AX45
196EH7
$295.00
Compact
One Arm Drive
196AL16
Quick Release Steel
Extension Handle
Threaded Axle
196AX1
Composite Footplate
NC
196F5
Footplate
NC
$152.00
$162.00
NC
Long
Elevating Hanger - Ext MountN/A w/ Alum Angle Adj Front Mount footplates.
NC
NC
Front Hangers
NC
196WL24
4. REAR WHEELS / REAR SEAT HEIGHTS (CONT)
$1,276.00196HM1
Extension Handle (Pair) E0961A1
NC
High Mount Pull $63.00
A1
NC
Elevating Hanger - Front MountOnly available w/ front mount alum angle adj footplates and 14"-22" width
196H141
196H161
Angle Adjustable Back (-15° to +3°)
NC
196B5 Med (13"-17")Backrest Height
NCStandard
A2 One Arm Drive Adj. Axle Plate
Short NCMedium
A2 Quad Quick Release Steel N/A on Spoke
196E1
196WL1
196E5
196BT10196BT100
Push Handles
$286.00Folding Push Handle with Ht. Adj. Back
Back Type
Do Not Mount
Axle
A2
NC
NC
$319.00
A1
$313.00
Tall (16"-20")
5. WHEEL LOCKS
6. HANGERS AND FOOTRESTS
7. BACKREST / SEATING
A2
Customer Service: (800) 263-3390 Fax: (800) 561-5834 E-mail: [email protected] www.sunrisemedical.ca Specifications are subject to change without notice. © 2019 Sunrise Medical Canada Inc. MK-100379-CAN REV (1).
Page 4 of 5
Some limitations when used with the Angle Adjustable Back in the rear most settingPlease circle a setting, will default to 11" if no selection is made
9" 10" 11" 12" 13"
Flip Back HA Classic N/A w / 14"-15" depth
Backpack - Black/Charcoal AdultSeat Pouch Black
1.5" Auto Buckle w/ ClampsPositioning Belt Slide Clamps
A1 is client responsibility. A2 is clinical justification.
$71.00$90.00
$111.00
196BU1
Padded Swing-Away STD (9" to 13")
1961A01
196A86 Anti Tips (Pair) Low Profile
A1A1
Omit Armrest
Back Upholstery
$351.00Dual Post Flip Back Ht Adj
7. BACKREST / SEATING (CONT)
Flip Back Ht Adj Classic (11"-15")$313.00
1968A01
$77.00
196SG29
Standard Upholstery
$150.00
NC
Backrest Tension Adj Ballistic Nylon $175.00
196SG33
196BU70
196AA65 Flip Back Ht Adj LITE (10"-15")
196A141
Armrest Options
196A804
CaddyA1
Setting
$331.00
To inquire about any unique customization for Quickie products, contact: Phone: (800) 263 - 3390, Fax: (800) 561 5834
Positioning Belt
1968A03
Matte Frame Colors Additional Options Through Built for MeNC
8. ARMREST / SIDEGUARDS
Matte Black196C116196C150
Plastic - Standard (8.5" High)
NC
$256.00
$83.00
196AA104196AA105
196BU14
$313.00Single Post Ht Adj - Low (8.25"-12.25")
196AA103
NC
Miscellaneous$103.00196A1
Crutch Holder
Matte Electric Blue
A1
9. KEY OPTIONS
$313.00
Reference page 12 of the AADL Wheelchair APL for options and catalogue numbers for A wheelchairs.
$173.00
196AA14
Quickie Black Spoke Guard196AT1 Anti Tips (Pair) $105.00
196AA159
$173.00
Single Post Ht. Adj - Std (9.75"-14.75")
Armrest - Padded Swing Away
Full Length - Full (14")
196AA18
Side Guards
Armrest - Height Adjustable
196A2100 $106.00
Pack Accessories
196AM23
Quickie Clear Spoke Guard
Gel Cover For Swing Away Arms (pair)
NC196AM24
$145.00
Omit Back Upholstery ($21.00)
$145.00
Armpad - For Height Adjustable
1964A01Spoke Guards
Desk Length (10")
Plastic - Low (6.5" High)
1964A02
Anti Tips
NC
10. COLOR
Customer Service: (800) 263-3390 Fax: (800) 561-5834 E-mail: [email protected] www.sunrisemedical.ca Specifications are subject to change without notice. © 2019 Sunrise Medical Canada Inc. MK-100379-CAN REV (1).
Page 5 of 5
Lower Leg Length Range Matrix
Front Seat Height Matrix Cont.
APPENDIX
A1 is client responsibility. A2 is clinical justification.