quickie qxi aadl
TRANSCRIPT
EIF6, October 2018
PV: PC:( ) Fax: ( )
PV: PC: ( ) Fax: ( )
See Seat Height Matrix on page 2For 14" sizes use E1236
Frame Depths equals Seat Depths.
Cushion name or part number must be filled out with desired width and depth
Dealer Phone:Ship To City:
Standard Frame
Seat Depth
14" NC196W7
196W10
196SL6
196W11
Transit
Dealer Address:
Fax
$363.00
Omit Seat Sling -$20.00
196W6
$276.00
196W8
Quickie QXi (Adjustable Axle) 265 lbs
196W9
$2,435.00
18" NC19"
196SL1
196QC03
196JC20
$276.00
To order any JAY cushions on-chair, please see the JAY price list.
196SD716" NC
JAY Cushions (Optional)
$276.0020"
196SD10
15"15"
2. SIZE / SEATING
NC
17"
NC
Transit System WC19
196W5 14" NC
196FS30
Option # Option #
Quickie QXiAADL
Dealer Acct #:
Mark For:Date:
Quote Order
Ship To:
PO#:
Submitting for:
Dealer:
Dealer City:
Confirmation Email:
1. FRAME
Attention:
Frame Width
Confirm Via:
Address:
ADDITIONAL SHIPPING INFORMATIONDealer Contact:
196WM78
Base Model
NC
Address:
17"18"19"
Width:
20"
Cushion Name or Part #
NCSeat Sling
196QC02
Price
Email Ship To Phone:
Definition
Hemi Frame196FS9
Price
Frame Style
NC
196TO38
Definition
NC
NC
NC
$276.00
16"
196SD13
NC
Made-to-Order Seating196QC01 Surefit NC
NC196SD11
Standard Seat Sling
NC
196SD71
196SD9 196SD8
Depth:ConfigurfitJayFit
Price ListJAY Bundled Cushion
ORDER INFORMATION: Customer Service: 800-263-3390 Fax: 800-561-5834 www.sunrisemedical.caSpecifications are subject to change without notice. Copyright © 2018 Sunrise Medical Canada Inc. MK-100025 Quickie QXi REV F
Page 1
Quickie QXi featuring the Jay ION™ cushionQuickie QXi, Ultra Lightweight Adjustable Folding Wheelchair
12.5" & 13" only available w/ Alum Angle Adj Footplate NC NC NC NC NC NC NC NC NC NC NC NC NC NC
NC
See Rear Seat Height Matrix See Rear Tire & Wheel Matrix for availability
See Rear Tire & Wheel Matrix for availability Natural Fit only available w/ 22, 24, 25 Lite Spoke. Plastic NA w/ 25, 26" See Apendix for Rear wheel / Handrim matrix
196RW94
24" Mag Wheel 5 Spoke
196SH23
-$43.00
Aluminum Anodized
196HR26
196RW25
22" Mag Wheel 5 Spoke
$389.00
$113.00
196HR32
196RW103
Hemi Frame12.0" - 15.0"
196RW93
196RW90
Omit26" Lite Spoke Wheel
22" Mag Wheel
25" Lite Spoke Wheel NC
20" Mag Wheel
Natural Fit - Standard GripNC
196HR23196HR22
Rear Wheel Size
196HR1
196RW8NC
14.0" - 17.5"26" Rear Wheel 16.0" - 19.5"
15.5" - 19.0"
NC
NCNC 14.5" - 18.0"
13.0" - 16.5"22" Rear Wheel
196RH15
Schwalbe Marathon Plus Evolution
196RT39
24" Lite Spoke Wheel NC
13.5" - 17.0"
196RT21
NC
24" Rear Wheel 15.0" - 18.5"25" Rear Wheel
High-Pressure Clincher Black
196RH26
19"
196RH11
196RH18
196RH27
196RH17
196RW1
20" Lite Spoke Wheel $286.00
20" Mag Wheel 5 Spoke
NC
NC
NC
196SH42 14.5"
16.5"
19.0"
8" Polyurethane 8" x 1.5" Semi Pneumatic
13"
196SH17
12.5"
Std Frame
196SH18
14.0" - 17.5"
196RH1615"
Rear Wheel Size
6" x 1.5" Semi Pneumatic
Caster Fork
196SH40
196CW5
196CF17
196CW44
17.0" Front Seat Height Matrix
NC196SH14196SH35
12.5"196SH15196SH16
196SH34
196CS1
1 1/2"196CS5
NCNC
NC
196HR28
NC15.5"
7"
18.0"
196CS9
Caster Stem Bolt
16"
$286.00
196RT3
16.5" Pneumatic
NC
196HR27
NC
NC18"
NC
18.5"
196RW102
Seat Squeeze Matrix
22" Lite Spoke Wheel196RW91
NC
$141.00
196RH19 17"
196RW3
196RH21
196RW92
Natural Fit - Super Grip$346.00
$422.00
196RH20
NC
196RW104 196HR4
Handrim
24" Mag Wheel
NC
17.5"
Rear Seat Height Matrix
12"
196CF12
196CW34196CW35
NC
NC
196CW39
20" Rear Wheel
14"
196CW32
NC
196CF23
Rear Seat Height
$221.00NC
Pneumatic w/ Airless Insert
14.5" Rear Wheel Tire
196RT1
196RT2
3. CASTERS / SEAT HEIGHT
196CW3
Standard3/4"
13.0"
14.0"
16.0"
196RH10
196RH14
12.5" - 16.0"
196RH13
NC
$130.00
5" x 1.5" Semi Pneumatic
17.5"
18.5"
196SH41
NC
$98.00
NC13.5"
NC
NC
4" x 1.25" Semi Pneumatic
Caster Wheels4" Low Profile Polyurethane
3.5" (standard stem bolt only)
196CW76" Polyurethane NC
$93.00
NC
$403.00The Surge LT - Oval w/Gription Strip $488.00
Natural Fit - No Thumb Grip$446.00
Q-Grip Neoprene Coated
The Surge - Oval w/Gription Strip
$130.00
NC
5" Low Profile Polyurethane
196RH9
6"
Plastic
196RH12
196CF715.25"
196SH20
19.5"196SH21
See Front Seat Height Matrix. 12.5 & 13.0 only available w/ 60 ° hangerNC
196SH12196SH13
15.0"15.5"
Full PolyNC
Front Seat Height
$98.00
4. REAR WHEELS / REAR SEAT HEIGHTS
13.5"
NC
Frame Depth Max Seat Squeeze14" 2.0"
15" - 16" 2.5"17" - 18" 2.5"19" - 20" 3.0"
ORDER INFORMATION: Customer Service: 800-263-3390 Fax: 800-561-5834 www.sunrisemedical.caSpecifications are subject to change without notice. Copyright © 2018 Sunrise Medical Canada Inc. MK-100025 Quickie QXi REV F
Page 2
Measure from front of back post to center of rear axle
Available only with 24" MBL Lite spoke wheels. Std Aluminum black handrim
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 Loop Gel Cover For Hangers (Pair)
Integral Push Handles, Folding Height Adjustable & Omit is 8° for Standard Backrest, Straight for Angle Adj. Backrest
Fixed Sleeve 3⁰Fixed Sleeve 0⁰
NC196CC5
1.5"
196CC6
196CC4 NCNC
$286.00196WL23
Hanger & Footplate Options
$471.00
2.5"
196F3Elevating Hanger - Front MountOnly available w/ front mount alum angle adj footplates and 14"-22" width 206
Aluminum Angle Adj. Footplate
196H145
Threaded Axle
2"
NCAdjustable Axle Options
3"NC
NC
1"
NCNC
Adjustable sleeve
Axle
$163.00
NC
196AX11
$134.00
196AL16
196WL12
196CC3NC196CC2
196AS6196AS5
196H159Articulating Hanger NA w/ Alum Angle Adj Front Mount footplates.
Back Type
70° Swing In/Out Hanger
Extension Handle (Pair) High Mount Pull
Unilateral Wheel Lock RightUnilateral Wheel Lock Left
196HL121968A02
NC
Integral Push Handles
Center of Gravity
NC
196E5 Long
196WL1
196E2196H139
$304.00
Footplate
NC
NC
$141.00
High Mount Push
NC
$157.00 196F271
Elevating Hanger - Ext MountNA w/ Alum Angle Adj Front Mount footplates.
Composite Footplate196F1
Composite Angle Adj (16"-22"w)
80° Swing In/Out Hanger
196B9
$304.00
196H160
196F5
Tall (16"-20")
Omit Hanger & Footplate
196E1NC
NC
Compact
$1,239.00
196WL30
Wheel Lock
196WL24
196H144
196H141
196WL2
Do Not Mount196WL10 Omit Wheel Lock
Front Hangers
$146.00
196BT100
196B5
NC
Quick Release Steel
196AX45
60° Swing In/Out Hanger
196BT10
196H161
Backrest HeightNC
NC
Extension Tubes
MediumShort
$157.00
Quad Quick Release Steel NA on Spoke
NC
One Arm Drive
196HM2 NC196HM1 NC
One Arm Drive Adj. Axle Plate
196AS4
196EH7
$286.00
NC
Extension Handle
Rear Tire & Wheel Matrix
Angle Adjustable Back $319.00
$146.00
Med (13"-17")
-$16.00
$65.00
NC
Folding Push Handle with Ht. Adj. Back
196PH5
5. WHEEL LOCKS
6. HANGERS AND FOOTRESTS
7. BACKREST / SEATING
Push Handles
Fold-Down Push Handles Only available with Adjustable Upholstery. Used in combination w/Angle Adjust only avail in 16"-20" back height
$151.00
NC
Standard NC
196PH6
196AX1
4. REAR WHEELS / REAR SEAT HEIGHTS (CONT)
196PH17 $278.00
196PH2 Omit Push Handles
ORDER INFORMATION: Customer Service: 800-263-3390 Fax: 800-561-5834 www.sunrisemedical.caSpecifications are subject to change without notice. Copyright © 2018 Sunrise Medical Canada Inc. MK-100025 Quickie QXi REV F
Page 3
*Reference XXXBU89 for billing
Some limitations when used with the Angle Adjustable Back in the rear most setting Please circle a setting, will default to 11" if no selection is made
9" 10" 11" 12" 13"
Flip Back HA Classic NA w / 14"-15" depth
Armpad - For Height AdjustableArmrest - Padded Swing Away
Back Upholstery
196AA159 Flip Back Ht Adj Classic (11"-15") $341.00Dual Post Flip Back Ht Adj
Side Guards
Purple Heart
Price List
8. ARMREST / SIDEGUARDS
Armrest - Height Adjustable
$304.00
1968A01
$168.00$168.00196SG29
196AM24
$341.00
Armrest OptionsGel Cover For Swing Away Arms (pair)
Plastic - Standard (8.5" High)
196AA65
$141.00
7. BACKREST / SEATING (CONT)
196C113 Titanium Color Paint NC
196C103 Rootbeer NC
Sunrise Orange NC196C145
196C8 Yellow
196C148
NC
Additional Options Through Built for Me
Mauve Pink NC
$330.00
196C114 Sparkle Silver NC
196C108196C144
To inquire about any unique modification for Quickie products, contact: Phone: (800) 263 - 3390, Fax: (800) 561-5834
Electric Blue NCStars & Stripes
Hot Sparkle Pink NCGreen Apple NC
196C147
196C142 Mossy Oak Camouflage 196C43
Zebra (Choose above base color) Std with White unless above base paint is chosen NA w/ Blk, Matte Black, Blk Opal, Titanium)
196C126 Glow NC
Desert Camouflage $330.00NC
$330.00196C143 Evergreen NC 196C42 $330.00
196C35 Candy Red NC 196C112
196C36 Candy Blue196C38 Blue Opal NC
NCNC196C141 Black Cherry
196C10196C152
Matte Electric Blue
Matte Purple
Matte Black Cherry
Matte Evergreen196C150
196C14
NCNC
NC196C2
196AA103
Matte Black
NCNC
Personalized Frame Color
Black Opal
Candy Purple
196C149
NC 196C151
Quickie Clear Spoke Guard
Positioning Belt
196A1
$304.00
Standard Frame Colors Matte Frame Colors
Crutch Holder
1964A02
Aztec Gold NC 196C116 NC196C140
$304.00Single Post Ht Adj - Low (8.25"-12.25")
Black (Not avail as base w/Zebra)
Setting
Anti Tips (Pair)
196A2100
196VU13
Flip Back Ht Adj LITE (10"-15")
Padded Swing-Away STD (9" to 13")196AA18
NC
196SG33
196AA14
Single Post Ht. Adj - Std (9.75"-14.75")
Backpack - Black/Charcoal Adult $100.00Seat Pouch Black $75.00 1968A03
Miscellaneous
NC196AM23
JAY Back (see Order forms)
$81.00
9. KEY OPTIONS
Plastic - Low (6.5" High)
Purple Heart with Air Force Patch
196VU5
NC
$55.00$87.00
JAY Backs
Omit Armrest
1961A01
196A804 Positioning Belt Slide Clamps 1.5" Auto Buckle w/ Clamps196A141
$103.00
NC
196JB01
Pack Accessories
NC
196AA104
196BU71 Backrest Tension Adj 3DX Vented*Reference 186BU71 for billing
$402.00
$249.00
196VU9Backrest Tension Adj EXO
196AA105
Purple Heart with Coast Guard
NC
NC196VU11
Desk Length (10")
Purple Heart with Navy Patch
US Army Patch
NC
NC196VU10
US Air Force Patch196VU4
196VU8
US Coast Guard
Purple Heart with Marines PatchNC
196VU2
$422.00
196BU89
196BU88 Standard Upholstery EXO
Caddy
$146.00
Full Length - Full (14")
US Marines Patch NC
NC
NC
Spoke Guards$108.00 $141.00Quickie Black Spoke Guard
NC
Purple Heart with Army Patch
196VU3
196AT1Anti Tips
1964A01
196VU12
US Navy Patch
NC
10. COLOR
196VU1196BU1 Standard Upholstery Military Service Patches
$67.00
196BU14 Omit Back Upholstery -$20.00
196BU70 Backrest Tension Adj Ballistic Nylon*Reference 186BU70 for billing $379.00
ORDER INFORMATION: Customer Service: 800-263-3390 Fax: 800-561-5834 www.sunrisemedical.caSpecifications are subject to change without notice. Copyright © 2018 Sunrise Medical Canada Inc. MK-100025 Quickie QXi REV F
Page 4
Lower Leg Length Range Matrix
Front Seat Height Matrix Cont.
APPENDIX
ORDER INFORMATION: Customer Service: 800-263-3390 Fax: 800-561-5834 www.sunrisemedical.caSpecifications are subject to change without notice. Copyright © 2018 Sunrise Medical Canada Inc. MK-100025 Quickie QXi REV F
Page 5