form 16-950c storm torque sp order form february 15 2019...lc1720 lc1816 lc1818 lc1820 lc1916 lc1918...

MED bilitym

PAGE 1 of 13For the most current pricing information visit www.invacare.ca

Note: All specifications and dimensions are approximate.Form:16-961AADL, Rev 10/1/19

INVACARE POWER BASES

Storm Torque SP Base with MK6i Electronics

3GTQSPBASE-MM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $7,500Select STF(1): 3GTQSPSLOW 16.75”(2) . . . . . . $250

3GTQSPLOW 18.25”3GTQSPMED 19.25”3GTQSPTALL 20”

NOTE: 1. Seat-to-floor height is measured at the front of the seat pan based on a standard seat size.2. It is highly recommended that batteries be ordered on-chair when the 16.75” STF height is chosen.

TRANSPORT TIE DOWN

TRBKTS Wheelchair Transport Brackets(1) . . . . . . . . . . . . . . . . . . . . STD

NOTES: 1. For unoccupied use only

USER WEIGHT LIMITS

U300 Weight Capacity up to 300 lbs . . . . . . . . . . . . . . . . . . . STD

DRIVE TYPE OPTION

PERF Performance 4-Pole Motor . . . . . . . . . . . . . . . . . . . . . . . . . .STD

FRAME TYPESFS Short Base . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .STDLFS Long Base . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$432CASTER OPTION1228-3 8” x 2 1/4” Semi Pneumatic Casters Light Grey . . . . . .STD

1251-3 8” x 2” Pneumatic Caster . . . . . . . . . . . . . . . . . . . . . . . . N/CTIRE OPTIONS 1430-3T 14” x 3” Pneumatic Tire . . . . . . . . . . . . . . . . . . . . . . . . . . . . .STD

1431-3T 14” x 3” Tire with Foam Filled Inserts . . . . . . . . . . . . N/C

WHEEL OPTION (PAIR)

RWS Rear Wheel Standard . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .STD

FENDER OPTION

FDR Fender . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N/C

FRAME FINISH24P Wet Black . . . . . . . . . . . . . . . . . . . . . . . . N/C

29P White Snow . . . . . . . . . . . . . . . . . . . . . . . . N/C30P Sunny Yellow . . . . . . . . . . . . . . . . . . . . . . . N/C

60P Silver Metallic . . . . . . . . . . . . . . . . . . . . . . . . N/C

61P Electric Red . . . . . . . . . . . . . . . . . . . . . . . N/C

62P Electric Blue . . . . . . . . . . . . . . . . . . . . . . . . N/C

105P Midnight Blue . . . . . . . . . . . . . . . . . . . . . . . . N/C

115P Black Prism . . . . . . . . . . . . . . . . . . . . . . . . N/C

116P Sunkissed Orange . . . . . . . . . . . . . . . . . . . . . . . . N/C

117P Tangerine Red . . . . . . . . . . . . . . . . . . . . . . . . N/C

119P Bubblegum Pink . . . . . . . . . . . . . . . . . . . . . . . . N/C

120P Grape Madness . . . . . . . . . . . . . . . . . . . . . . . . N/C

127P Grasshopper Green . . . . . . . . . . . . . . . . . . . . . . . N/C

CONTROLLERS

MK690ACC 90 Amp Controller with Actuator Control . . . . .STD

GTRAC G-Trac Electronic Gyroscope Module . . . . . . . $988

STANDARD DRIVER CONTROLSPJAPM SPJ Plus with Mode Switch for

Joystick Actuator Operation(1) . . . . . . . . . . . . . . . . . . . . . . STD NOTE: 1. Allows actuator operation through the driver control. Includes port forattendant switch.

Client Height:

Client Weight (lbs):

A. Seat to Shoulder:

B. Trunk Depth:

C. Chest Width:

D. Knee to Back:

E. Seat to Top of Head:

F. Elbow to Hand:

G. Seat to Elbow:

H. Hip Width:

I. Knee to Heel:

Cushion Thickness:

To ensure system is accurately configured please fill in all required

Quote Order Date of Order: ________ Dealer Account #: ____________________

Dealer Name: ________________________________________________

PO #: ____________________________ Tag _______________________

Purchasing Contact: __________________________________________

Phone: __________________________ Fax: _______________________

E-mail: ______________________________________________________

RTS/Therapist: _______________________________________________

Ship to Address: _____________________________________________

City: ____________________________ Province: __________________

Postal Code: _____________________ Client Gender: M F

Special Client Conditions: ____________________________________

REQUIRED MEASUREMENTSREQUIRED INFORMATION

Storm Torque SP Base with Modular Maxx CG Power Positioning System

CDN PRICE LIST AND ORDER FORMPrice Effective October 1, 2019

Customer Service: 1.800.668.5324 I Fax: 1.800.668.5478 I www.invacare.ca

FOR AADL ONLY, AADL CAT. # W558

MEDmobility 5711- Calgary Trail NW Edmonton AB T6H 2K1

P: 780-437-3300 F: 780-430-9381

www.medmobility.ca

Vendor #0000612578-001

Discount 8%

MEDmobility AADL Vendor #0000612578-001

Seating Components 6%

MED bilitym



MULTIPLE DRIVE CONTROLS OPTIONS

PWH Harness required for Expandable Electronics(1) . . . . . . . N/C

CMPJM6U MPJ+ Multiple Drive Joystick with Colour Display . $875

ASLRDYM6 MK6 Display Only (No Driver Control)(2) . . . . . . . . . . . . .$242

NOTES:

1. Harness is required to interface joystick or MK6i display withexpandable controllers.

2. For you ASL Drive System needs, pleaser refer to the ASL AlternativeDrive Controls and Accessories form.

ALTERNATIVE PORPORTIONAL CONTROL SYSTEMS

1558MM6 Compact Joystick with Display . . . . . . . . .$1,097

ALTERNATIVE DIGITAL CONTROL SYSTEMS

SNPM6 Sip-N-Puff Digital Interface Box(1) . . . . . . . . . . . . $2,135

NOTE: 1. Must also use either a Multiple Drive Joystick or MK6i Display.

SIP N PUFF KITPKG32666 Therafin Sip-N-Puff Breath Tube kit . . . . . . . $440

ADDITIONAL CONTROL CHOICES

1558M6 Compact Joystick - Less Standard Mount . . . . . . . . . . . . . . . . . . . . . . . . . $937

PACM6 Proportional Attendant ControlWith Quick Release Mount . . . . . . . . . . . . . $1,024

JOYSTICK MOUNTING HARDWAREQLAM Quad Link Retract Joystick

Mount CMP+ (1) . . . . . . . . . . . . . . . . . . . . . . . $358

QLA Quad Link Retract Joystick Mount SPJPLUS(1) . . . . . . . . . . . . . . . . . . . . $358

LEFT Left Handed Joystick Mount . . . . . . . . . . . . . . . . . . . N/C

NOTE: 1. QLAM6 and QLA includes Adjustable Height Joystick Mount.

\ELECTRONIC ACCESSORIES1813M6 MK6i Programmer with Professional Memory

Card . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$685

1813SD Professional Memory Card . . . . . . . . . . . . . . . . . . . . .$112

AUX12M6 Auxiliary Module for 1 & 2 . . . . . . . . . . . . . . . . . . . . . .$706

AUX34M6 Auxiliary Module for 3 & 4 . . . . . . . . . . . . . . . . . . . . . .$706LINX ELECTRONIC ACCESSORIES

BATTERY TRAY TYPE

GP24 Group 24 Battery Boxes . . . . . . . . . . . . . . . . . . . . . . . . . . . . N/C

INSTALLATION OF BATTERIES

24BATTERY 24 Gel Battery (On Chair) . . . . . . . . . . . . . . . . . . . . . . . . . . $840

BATTERY CHARGER OPTION

110CHARGER 110 Volt Battery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N/C

OMIT Omit Charger . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N/C

MISCELLANEOUS ACCESSORIES

1303 Wheel Locks (1) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $90

9205-3 Upgraded Monroe Suspension Shocks . . . . . . . . . . . . $150

NOTE: 1. Not available with pneumatic tires.

NOTES:

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Dealer Name: _______________________________________________

Dealer Account Number: ____________________________________

PO #:_______________________________________________________

Tag: _______________________________________________________

Invacare Storm Torque SP Base Modular Maxx CG Power Positioning System

MED bilitym



SPECIALTY CONTROLS TO BE USED ON CHAIR PLEASE SPECIFY*

Type: __________________________________________________

Specialty Control Mount: Right Left Specify _________________________

Display Mount:Right Left Specify _________________________

Mode Switch Mount:Right Left Specify _________________________

On/Off Mount: Right Left Specify _________________________

List Other: ________________________________________ Specify Mounting Location: ______________________________

*Please order on form 18-395C ASL or specify drive controls to beused if not ordered with chair.

SYSTEMS MUST SELECT ONE SYSTEM

Modular Maxx CG Tilt (50°) Only System . . . . . . . . . $6,969Part # MDCGT-50Part # MDCGT-45(1)

Modular Maxx CG Tilt (50°) and Power Recline (170°) System w/Extended Shear Reduction (ESR) . . . . . . $11,569Part # MDCGTRESR-50Part # MDCGTRESR-45(1)

Modular Maxx CG Tilt (50°) and Power Recline (170°) System w/Synchronized Power Sliding Back (PSB) . . . $12,069

Requires 2-6 function Enhanced ElectronicsPart # MDCGTRPSB-50Part # MDCGTRPSB-45(1)

NOTE:1. Tilt will be reduced to 45° if adding an Elevating Lift Seat Module

Modular Maxx Recline Only System (170°) withExtended Shear Reduction (ESR) Part # MDRESR . . . $10,350

Modular Maxx Recline Only System (170°) withSynchronizes Power Sliding Back (PSB)(1) . . . . . $10,850Part # MDRPSB

NOTE:1. Only available on seat sizes 17” wide and greater.

Modular Maxx Elevate Lift Seat Only System(1)

12” Elevation - up to 250lbs Part # MDES12 . . . . . . . . . . . . $4,995

NOTE:1. Not available on seat sizes greater than 20” wide by 20” deep,

call Customer Service for options.

ADD: ELEVATING LIFT MODULE FOR TILT & TILT RECLINE

12” Elevating Lift Seat Module(1)(2)(3) (Scissor Mechanism)Elevation - up to 250lbs max. Part # ESM12 . . . . . . . . . . . . $2,495

NOTES: 1. Uses an integrated Tilt/Lift mechanism, tilt is 45° and the seat to

floor height is not affected by the Elevating Lift Seat.2. Not available on seat sizes greater than 20” wide by 20” deep,

call Customer Service for options.3. For weights greater than 175lbs tilt while elevated is not

available. Call Customer Service for details.

MODULES MUST SELECT SYSTEM-TO ADD MODULES

Recline Body Fit (Minimum finished back widths of 16”) . . . . . . . . . .$995(This option allows the seat back to be narrower than the seat pan. For example an 18”

back pan width with a 20” seat width is accomplished by selecting “2” Narrower” option.)

2” Narrower Part # BFS2 4” Narrower Part # BFS4

10° Fixed Anterior Assist(1) Part # FA10 . . . . . . . . . . . $750

5° Fixed Anterior Assist(1) Part # FA5 . . . . . . . . . . . . . N/C

5° Fixed Pre-Tilt(2) Part # PRETILT . . . . . . . . . . . . . . . . . N/C

8° Precline Module(3) only available with Recline . . . . . . . N/CPart # PRM8

30° Precline Module(3) only available with Recline . . . . . .$500Part # PRM30

Single Post Angle Adjustable Fold Down Back(4)(5)(6)

(Folds to 25° forward) . . . . . . . . . . . . . . . . . . . . . . . . . . .$750 Matrx Interface Part # SPBMI

(Select Matrx back from upgradeable section page 6)

NOTES: 1. This module may limit front rigging options. The 10° Fixed

Anterior Assist option adds approximately 3.6” to the seat tofloor height at zero degrees(level). The 5° Fixed Anterior Assistadds approximately 2” to the seat to floor height at zerodegrees(level).

2. This Fixed Pre-tilt option adds approximately 2” to the front seatto floor height.

3. Total degrees of recline is 170° ie: if 30° degrees of precline isused, then 140° degrees of recline will be available

4. Single Post Back is an angle adjustable back between 73°and 109° in 6° increments from 17° forward to 19° back. Theback folds down and is only available for 16”-20” seat widths& 21”-24” back height. A minimum 4” gap from bottom ofback to seat pan is required.

5. This option is not available with a vent tray and has a 250lbweight capacity.

6. Cane mounted armrests are not available with this option

Dealer Name: _______________________________________________


PO #:_______________________________________________________

Tag: _______________________________________________________

NOTE: Systems Include Seat Pan, Back Pan, and Standard Armrests. They are designed for use with a 2”- 3” cushion


MED bilitym



SEAT SPECIFICATIONSSelect Seat Width and Ultra Rail Width Adjustment

16” 17” 18” 19” 20” (Adjustable from 16”- 20”)Part # SW116 SW117 SW118 SW119 SW120

19” 20” 21” 22” (Adjustable from 19” - 22” )Part # SW219 SW220 SW221 SW222

Select Seat Depth and Ultra Rail Depth Adjustment16” 17” 18” 19” 20” 21” (Adjustable from 16” - 21”)

Part # SD116 SD117 SD118 SD119 SD120 SD121

19” 20” 21” 22” 23”(Adjustable from 19” - 23”)Part # SD219 SD220 SD221 SD222 SD223

Small Adult Sizes: Select Seat Width(2)

14”(1) 15”(1) (Adjustable from 14” - 17”)Part # SW314 SW315

Select Seat Depth

14”(1) 15”(1) 16” 17”18” (Adjustable from 14” - 18”)Part # SD314 SD315 SD316 SD317 SD318

NOTES:

1. Small Adult Seat Size - Weight limit is 175lbs on these seatsizes and if Recline is selected it may be limited to 165°of recline. If one of these widths/depths are selected, you canonly select one of smaller depths/widths.

2. Other widths available, please call Customer Service.

LAP BELTS AND CHEST STRAPS Chest Strap 5” W x 24” L (1) Part # CS . . . . . . . . . . . . . . .$210

Padded Lap Belt 2 point(1)

Part # PLB2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$170 Padded Lap Belt 4 point(1)

Part # PLB4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$215

Push Button Style Seat Belt . . . . . . . . . . . . . . . . . . . . STDPart # 48” BELT48 60” BELT60 71” BELT71

NOTE: 1. 67” length only option.

CUSHION COVER REFERENCE GUIDE

MATRX SEAT CUSHION OPTIONS*

Matrx Libra Seat Cushion 14”w-20”w . . . . . . . . . . . . .$745LC1414 LC1416 LC1516 LC1518 LC1520LC1616 LC1618 LC1620 LC1716 LC1718LC1720 LC1816 LC1818 LC1820 LC1916LC1918 LC1920 LC2016 LC2018 LC2020

Matrx Libra Seat Cushion 21”w - 22”w . . . . . . . . . $1,025LC1622 LC1722 LC1822 LC1922 LC2022LC2118 LC2120 LC2122 LC2218 LC2220

Matrx PS Seat Cushion 16”w - 20”w . . . . . . . . . . . . . .$569PS1616 PS1618 PS1620 PS1816 PS1818PS1820 PS2016 PS2018 PS2020

Matrx PSVF Seat Cushion 16”w - 20”w . . . . . . . . . . . .$589PSVF1616 PSVF1618 PSVF1620 PSVF1816PSVF1818 PSVF1820 PSVF2016 PSVF2018PSVF2020

Matrx PSP Seat Cushion 16”w - 20”w . . . . . . . . . . . . .$645PSP1616 PSP1618 PSP1620 PSP1816PSP1818 PSP1820 PSP2016 PSP2018PSP2020

Matrx Vi Seat Cushion 16”w - 20”w . . . . . . . . . . . . .$624MA1616-VI MA1618-VI MA1620-VI MA1816-VIMA1818-VI MA1820-VI

Matrx Vi Seat Cushion 21”w - 22”w . . . . . . . . . . . . . .$681MA2016-VI MA2018-VI MA2020-VI MA2218-VIMA2220-VI

FABRIC OPTIONS FOR CUSHIONS

Spacetex Fabric Option for Libra Cushion Part # SFLF . . . . N/C Infection Control Fabric Option for Libra Cushion

Part # ICFL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $50 Fusion Fabric Upgrade for Matrx Vi Cushion Part # FFV . . $150 Onyx Fabric Upgrade for Matrx Vi Cushion Part # OCUMA . . $100

Startex Fabric Upgrade for Matrx Vi Cushion Smooth Side up Part # SFVS . . . . . . . . . . . . . . . . . . . . . . . . . . $50

Fabric Side up Part # SFVF . . . . . . . . . . . . . . . . . . . . . . . . . . . $50

Dealer Name: _______________________________________________


PO #:_______________________________________________________

Tag: _______________________________________________________


Infection Control

Onyx

StartexMeshtex

FusionSpacetex

Cushion Meshtex Startex Infection Spacetex Fusion Onyx

Libra N/A STD $50 N/C N/A N/A

PS N/A STD -Reversible

STD -Reversible

N/A N/A N/A

PSP N/A STD -Reversible

STD -Reversible

N/A N/A N/A

Vi STD $50 $50 N/A $150 $100

MED bilitym



MATRX ELAN HEADREST PAD *

Matrx Elan Standard Pad . . . . . . . . . . . . . . . . . . . . . . .$310 Part # 6” Pad ESP6 10” Pad ESP10 14” Pad ESP14

Matrx Elan Standard Pad with Infection Control . . .$335 Part #6” Pad ESP6-IC 10” Pad ESP10-IC 14” Pad ESP14-IC

Matrx Elan Occipital Pad . . . . . . . . . . . . . . . . . . . . . . .$341Part #9” Pad EOP9 12” Pad EOP12

Matrx Elan Occipital Pad with Infection Control . . . .$366Part #9” Pad EOP9-IC 12” Pad EOP12-IC

Matrx Elan 4-Point Pad (11”W x 10”H”)Part #Standard Cover E4POINT . . . . . . . . . . . . . . . . . .$448

Infection Control E4POINT-IC . . . . . . . . . . . . . . . .$473

MOTION CONCEPTS HEADREST PAD

Motion Concepts Standard Part # MCSH . . . . . . . . . . . . N/CMotion Concepts Auto Style(1) Part # MCOH . . . . . . . . . .$350NOTE:

1. Comes STD with Fixed Mounting hardware; for use on Matrx PBor Elite Backs you must select removable hardware upgrade on P6.

HEADRESTS HCPCS code E0955

HEADREST MOUNTING HARDWARE OPTIONS

Fixed Mounting (non-removable)(1)(2)

Part # FM . . . . . . N/CMatrx Elan Headrest Hardware- Multi-Axis Removable

Part # MEHWRE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$266Motion Concepts Multi - Axis Removable Mounting

Part # MAHU . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$225OMIT: Headrest Part # OHR . . . . . . . . . . . . . . . . . . . . . . . . . . .N/C

NOTE: 1. Unless selecting a “Removable” hdwr option, the headrest

will come standard w/ Fixed Straight Mounting Hardware(non-removable)

FINISHED BACK HEIGHTS

Finished Back heights for Tilt Only Systems(1)(2)

18” 19” 20” 21” 22” 23” 24” 25”Part # FBT18 FBT19 FBT20 FBT21 FBT22 FBT23 FBT24 FBT25

Finished Back heights for Tilt/Recline Systems(3)

20” 21” 22” 23” 24” 25” 26” 27”Part # FBR20 FBR21 FBR22 FBR23 FBR24 FBR25 FBR26 FBR27

NOTES:1. Comes with standard cane height.2. 4” gap is recommended for Tilt systems to allow for the

seat cushion.3. 6” gap is recommended for systems with Recline/ESR.

STANDARD TILT BACK CANESMeasured from Seat pan to top of back cane

18” 20” 22” 24” . . . . . . . . . . . . . . . . . N/CPart # SBC18 SBC20 SBC22 SBC24

Select Cane Angle 75° 79° 85° 90° 95° 101° 106° 112° 116°Part # BA75 BA79 BA85 BA90 BA95 BA101 BA106 BA112 BA116

Angled (5°)Tilt Back Canes 20” 22” 24” . . . . . . N/CPart # ABC20 ABC22 ABC24

Select Cane Angle 81°84° 91° 96° 101° 106° 111° 117°121°Part # BA81 BA84 BA91 BA96 BA101 BA106 BA111 BA117 BA121

Endomorph Back Canes(1)(2) 22” Part # EBC22 24” Part # EBC24

Select: 1” 2” 4” Narrower . . . . . . . . . .$250 Part # EBCN1 EBCN2 EBCN4

10° Mid-Angle Tilt Back Canes(2) . . . . . . . . . . . . . . . . . .$250

18” 20” 22” 24” Part # TBC18 TBC20 TBC22 TBC24

NOTES:1. Comes standard with Cantilever Armrests Cane Mounted.2. Quick Height Adjustment on Backrest not available.3. Not recommended with upgradeable backs as height adjustment is limited.

BACK OPTIONSStandard Rehab Back and Back cushion . . . . . . . . . . N/CSRB16 - 16” wide SRB17 - 17” wide SRB18 - 18” wideSRB19 - 19” wide SRB20 - 20” wide SRB21 - 21” wideSRB22 - 22” wide

Additional Super Soft/HR Foam(1) Part # SS . . . . . . . . . . . . . . .$100 Matrx Fabric Upcharge Part # MFU . . . . . . . . . . . $100

Planar interface plate(3) . . . . . . . . . . . . . . . . . . . . . . . . . N/CRPIF16 - 16” wide RPIF17 - 17” wide RPIF - 18” wideRPIF19 - 19” wide RPIF20 - 20” wide RPIF21 - 21” wideRPIF22 - 22” wide

OMIT: Rigid Back Pan & Cushion(4) Part # ORBC . . . . . . N/COMIT: Back Cushion Only Part # OBC . . . . . . . . . . . . . N/C

NOTES: 1. Additional foam added may impact seat depth.2. Included with all Recline Systems when no back is selected.

May also be used as an interface for after market backs.3. Not available on tilt only or tilt/elevate systems, for use with

recline module.4. Not available with Recline/ESR or Recline/PSB.

Dealer Name: _______________________________________________


PO #:_______________________________________________________

Tag: _______________________________________________________


MED bilitym



BACK COVER REFERENCE GUIDE

UPGRADABLE BACK OPTIONS

High Back 16”-22”wide . . . . . . . . . . . . . . . . . . . . . . . . .$595MHB1616 MHB1618 MHB1620 MHB1716MHB1718 MHB1720 MHB1816 MHB1818MHB1820 MHB1916 MHB1918 MHB1920MHB2016 MHB2018 MHB2020 MHB2116MHB2118 MHB2120 MHB2216 MHB2218MHB2220

Matrx Elite Back 14”-20” wide (3” Contour) . . . . . . . .$766PBE1410 PBE1412 PBE1414 PBE1416PBE1418 PBE1420 PBE1510 PBE1512PBE1514 PBE1516 PBE1518 PBE1520PBE1610 PBE1612 PBE1614 PBE1616PBE1618 PBE1620 PBE1714 PBE1716PBE1718 PBE1720 PBE1814 PBE1816PBE1818 PBE1820 PBE1916 PBE1918PBE1920 PBE2014 PBE2016 PBE2018PBE2020

Matrx Elite HD Back 21”-22” wide (3” Contour) . . . $1,051 PBE2116-HD PBE2120-HD PBE2216-HDPBE2220-HD

Matrx Elite TR Back 15”-20” wide (3” Contour) ..........$866 PBE1516-TR PBE1518-TR PBE1520-TRPBE1616-TR PBE1618-TR PBE1620-TR

PBE1716-TR PBE1718-TR PBE1720-TR PBE1816-TR PBE1818-TR PBE1820-TR PBE1916-TR PBE1918-TR PBE1920-TR PBE2016-TR PBE2018-TR PBE2020-TR

Matrx Elite TR HD Back 21”-22”wide (3” Contour) . $1,151 PBE2120-TRHD PBE2220-TRHD

UPGRADABLE BACK OPTIONS - Cont

Matrx Elite Deep Back 14”-20” wide (6” Contour) . . .$918EDB1412 EDB1416 EDB1418 EDB1420EDB1510 EDB1512 EDB1514 EDB1516EDB1518 EDB1520 EDB1610 EDB1612EDB1614 EDB1616 EDB1618 EDB1620EDB1710 EDB1712 EDB1714 EDB1716EDB1718 EDB1720 EDB1810 EDB1812EDB1814 EDB1816 EDB1818 EDB1820EDB1910 EDB1912 EDB1914 EDB1916EDB1918 EDB1920 EDB2010 EDB2012EDB2014 EDB2016 EDB2018 EDB2020

Matrx Elite Deep HD Back 21”-22” wide (6” Contour) . $1,095EDB2120-HD EDB2220-HD

Matrx PB Back 14”-20” wide (5” Contour) . . . . . . . . . .$734 MPB1412 MPB1416 MPB1612 MPB1616

MPB1620 MPB1712 MPB1716 MPB1720 MPB1812 MPB1816 MPB1820 MPB2012MPB2016 MPB2020

Matrx PB Deep Back 14”-20” (7” Contour) . . . . . . . . . .$892 PBD1412 PBD1416 PBD1612 PBD1616PBD1620 PBD1712 PBD1716 PBD1720PBD1812 PBD1816 PBD1820 PBD2012PBD2016 PBD2020

Matrx PB HD Back(1) 20”-22”wide (5” Contour) . . . . . . $1,051 HDB2016 HDB2020 HDB2216 HDB2220

Matrx PB HD Deep Back(1) 21”-22”wide (7” Contour) . . . . . $1,209 DHD2016 DHD2020 DHD2216 DHD2220

NOTE: 1. The Heavy Duty PB Back and PB Deep Back are not available

on Recline systems with seat widths of 21” and 22”.

OTHER UPGRADABLE BACK OPTIONS

Super Soft Foam for Elite Back Upgrade Part # EBSS . . . . . . . .$103Fusion Fabric Upgrade High Back Part # FFUHB . . . . . . . . . . . . .$103 Onyx Fabric Upgrade for High Backs Part # OCUHB . . . . . . . . . . .$103 Onyx Fabric Upgrade for Contour Backs Part # OCUCB . . . . . . . .$103 Infection Control Cover for Elite/PB Backs Part ## WSCU . . . . . .$103

(purchased with back)

Infection Control Cover for Elite/PB Backs Part ## WSC. . . . . . .$150(purchased without back)

Chest Harness Interface Kit for Elite Back (1)(2) Part # CHIEB . . . .$103 Chest Harness Interface Kit for PB Back (1)(2) Part # CHIPB . . . . . . . $52

NOTES: 1. Does not include the chest strap.2. This Interface Kit is only Required for 4 point harnesses

4-way Stretch PolyesterMeshtex Infection Control

Fusion Onyx

Back Meshtex Polyester Infection Fusion Onyx

Contour N/A STD N/A N/A $100

High STD N/A N/A $100 $100

Elite/ Elite HD/Elite Deep STD N/A $100 N/A N/A

Elite TR/ Elite TR HD STD N/A $100 N/A N/A

PB/PB HD/PB Deep/PB HD Deep

STD N/A $100 N/A N/A

Dealer Name: _______________________________________________


PO #:_______________________________________________________

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TILT ARMRESTS

Adult Dual Post Adjustable Height With Quick HeightAdjustment Lever(pair) . . . . . . . . . . . . . . . . . . . . . . . . . STD

Select Size: (9.75”-12.75”)(12.75”-15.75”)(15.75”-18.75”)Part # DP1 DP2 DP3

Select : Flat pouch Glove BoxesPart # FP GB

Add: OutBack Arm Option(1) (each) Specify:Select: Right Part # OAR Left Part # OAL . . . . . . . . . . . . .$195

(Allows outward rotation while flipping back armrest)

Ultra Rail Mounted Flip Back Cantilever Maxx Tilt Arm(2)(3) (9”-12.5”) (pair) Part # RMCAN . . . . . . . . . . . . . .$488 Add Dual Post Module (pair) Part # DPM . . . . . . . . . . . . . .$250

Cantilever Arms for Endomorph Back Canes(see page 4)(pair) Part # CAFEBC . . . . . . . . . . . . . . . . . . . . STD

NOTES: 1. Only available with Dual Post and Recline Adjustable Armrests.2. Mounts to Seat Rail.3. Not available with Small Adult Sizes.

RECLINE ARMRESTS

Reclining Adjustable Height (9.5”-13”) (13”-16”) . . . . STD Part # RC1 RC2

Add: OutBack Arm Option(1) (each) Specify:

Select: Right Part # OAR Left Part # OAL . . . . . . . . . . . .$195

(Allows outward rotation while flipping back armrest)

Maxx Style Cane Mounted Height & Width & Angle Adjustable Cantilever Flip Back Armrest for Recline(2) Systems (pair) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$488

Select Straight Arm Configuration - range (9.5”-13”) Part # MCAN1

Select Curved Arm Configuration - range (12.5”-16”) Part # MCAN2

Outback Cantilever Recline Armrest (2)(pair) . . . $350Select Range: (9”-12”)(12”-15”)

Part # OCRA1 OCRA2

Cane Mounted Height & Angle Adjustable Cantilever Flip Back Armrest with/Quick Lock Mechanism(2) for Recline Systems (pair) . . . . . . . . . . . . . . . . . . . . . . . $488

Select Range: (9.5”-12”)(10”-13”)(13”-16”) Part # CANQ1 CANQ2 CANQ3

NOTES: 1. Only available with Dual Post and Recline Adjustable Armrests.2. Not available with small adult seat sizes.

ARMREST TUBE LENGTH - PLEASE SPECIFY

LEFT Armrest Tube Select: Full Part # ATFLDesk Part # ATDL

RIGHT Armrest Tube Select: Full Part # ATFRDesk Part # ATDR

ARM PADS

Modular Arm Pads(1) (each) . . . . . . . . . . . . . . . . . . . . . . .$50Left Full(14”) Part # MAPTFLDesk(10”) Part # MAPTDL

Must select Pad Insert:

Iskin - Integrated soft skin foam Part # ISSFL Startex Covered Visco foam Part # SCVFL

Right Full(14”) Part # MAPTFRDesk(10”) Part # MAPTDR

Must select Pad Insert:

Iskin - Integrated soft skin foam Part # ISSFR Startex Covered Visco foam Part # SCVFR

Standard Pads (each) . . . . . . . . . . . . . . . . . . . . . . . . . . . STDLeft Full(14”)Part # SAPFL Desk(10”) Part # SAPDL

Right Full(14”) Part # SAPFR Desk(10”) Part # SAPDR

Waterfall Arm Pads(2) (each) . . . . . . . . . . . . . . . . . . . . . N/C Left Full(14”)Part # WAPFL Desk(10”) Part # WAPDL

Right Full(14”) Part # WAPFR Desk(10”) Part # WAPDR

Flat Multi Position Pads (each) . . . . . . . . . . . . . . . . . . .$150Left Full(14”)Part # MPAFL Desk(10”) Part # MPADL

Right Full(14”) Part # MPAFR Desk(10”) Part # MPADR

Gel Pads (each)Narrow (2”x12”) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$88 Left Part # GAPNL Right Part # GAPNR

Wide (3.5”x12”) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$96 Left Part # GAPWL Right Part # GAPWR

Long (3.5”x14”) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$103

Left Part # GAPLL Right Part # GAPLR

Ergonomic Arm Trough (4.5”x13”) Left Part # EATL . . . . . . . . . . . . . . . . . $121

Right Part # EATR . . . . . . . . . . . . . . . . . $121

Flat Hand Pad (4.5”x 5”)(3) - Compatible Only w/Ergonomic Arm Trough

Left Part # FHPL . . . . . . . . . . . . . . . . . . . . . . . . . . .$85 Right Part # FHPR . . . . . . . . . . . . . . . . . . . . . . . . . . .$85

Arm Pad Storage/Cup Holder(3)

Left Part # APSL . . . . . . . . . . . . . . . . . . . . . . . . . . .$295 Right Part # APSR . . . . . . . . . . . . . . . . . . . . . . . . . .$295

OMIT: Armpads(4) (7/8” diameter tube) Part # OAP . . . . . . . . . . N/C

NOTES: 1. Requires interchangeable pad insert.2. Full length pad not compatible with the desk length

armrest tube if using Ultra Rail mounted Tilt Arms.3. Only available on Non-Joystick side.4. Must specify the Arm Tube lengths..

Dealer Name: _______________________________________________


PO #:_______________________________________________________

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ARMPAD ACCESSORIES

Elbow Block LEFT(1) . . . . . . . . . . . . . . . . . . . . . . . . . . .$195Select Pad Size and Extensions:

XS(3.25”x4.25”) Part # EBXL S(3.5”x5.25”) Part # EBSL

M(3.75”x5.75”) Part # EBML L(4.25”x6.5”) Part # EBLL

Vertical Extension: S(3”) Part # V3 L(5”) Part # V5 Horizontal Extension: S(5”) Part # H5 L(7”) Part # H7

Elbow Block RIGHT(1) . . . . . . . . . . . . . . . . . . . . . . . . . .$195Select Pad Size and Extensions:

XS(3.25”x4.25”) Part # EBXR S(3.5”x5.25”) Part # EBSR

M(3.75”x5.75”) Part # EBMR L(4.25”x6.5”) Part # EBLR

Vertical Extension: S(3”) Part # V3 L(5”) Part # V5 Horizontal Extension: S(5”) Part # H5 L(7”) Part # H7

Matrx Multi-Axis Upper Extremity Support(2) (each) .$257With Quick Adjustment Lever

Left Part # MACESL Right Part # MACESR CES - Cont

1” Offset Armrest Spacer (each) . . . . . . . . . . . . . . . . . . . .$125 (Allows seat width to increase by 2” with Dual Post or Recline Arms)

Left Part # OAS2L Right Part # OAS2R

1/2” Offset Armrest Spacer (each) . . . . . . . . . . . . . . . . . .$125 (Allows seat width to increase by 1” with Dual Post or Recline Arms)

Left Part # OAS1L Right Part # OAS1R

Multi Purpose Arm Pad Adapter Block(3) (each)

Quantity (___) Part # MPAPA . . . . . . . . . . . . . . . . . . . . . .$35

NOTES: 1. Prevents arm from slipping.2. Allows rotation of the armpad, only compatible with Gel pad,

Flat pad or Ergonomic Arm Troughs.3. Not available with Standard Pads or Waterfall Pads.

MAXX LATERALS (1)

Fixed Mounted Lateral Trunk Support LEFT . . . . . . . .$100Select Pad Size:

XS(3.25”x4.25”) Part # LATXL S(3.5”x5.25”) Part # LATSL

M(3.75”x5.75”) Part # LATML L(4.25”x6.5”) Part # LATLL

Fixed Mounted Lateral Trunk Support RIGHT . . . . . .$100Select Pad Size:

XS(3.25”x4.25”) Part # LATXR S(3.5”x5.25”) Part # LATSR

M(3.75”x5.75”) Part # LATMR L(4.25”x6.5”) Part # LATLR

NOTE: 1. These laterals are not available with Matrx PB, PB Elite Deep

and PB Deep Backs.

SELECT SWING AWAY HARDWARE ON NEXT COLUMN TO CONVERT ABOVE SUPPORTS:

MAXX STYLE SWING-AWAY HARDWARE(1)

Maxx Style Swing-away Multi-Adjustable Mounting Hardware LEFT Part # SALATL . . . . . . . . . . . . . . . . . . . .$195

(Standard with 1” telescoping link gives 0-2.75” medial offset (2))

Maxx Style Swing-away Multi-Adjustable Mounting Hardware RIGHT Part # SALATR . . . . . . . . . . . . . . . . .$195

(Standard with 1” telescoping link gives 0-2.75” medial offset (2))

Additional Telescoping Link(each) Quantity ( ) . . . .$75(Adding an additional 1” telescoping link gives up to 5.5” medial offset(2))

LEFT Part # ATLL RIGHT Part # ATLR

NOTES: 1. These laterals are not available with Matrx PB, PB Elite Deep

and PB Deep Backs.2. The amount of offset available may be impacted by back thickness.

MATRX FIXED LATERALS - FOR ELITE AND ELITE TR BACKS

Matrx Standard Fixed LEFT

Select pad: Standard (7.5” x 5”) Part # PBLSL . . . . . . $116 Small (5.5” x 3”) Part # PBSSL . . . . . . . . . $113

Matrx Standard Fixed RIGHT Select pad: Standard (7.5” x 5”) Part # PBLSR . . . . . . $116

Small (5.5” x 3”) Part # PBSSR . . . . . . . . . $113

Matrx Offset Fixed LEFT Part # PBOLL . . . . . . . . . . . . . . . $125

Matrx Offset Fixed RIGHT Part # PBOLR . . . . . . . . . . . . $125

MATRX SWING AWAY LATERALS - FOR ELITE AND ELITE TR BACKS

Matrx Lateral Trunk Support LEFT pad (each) . . . . .$108

Select Pad Size:

XS(3.25”x4.25”) Part # EPADXL S(3.5”x5.25”) Part # EPADSL

M(3.75”x5.75”) Part # EPADML L(4.25”x6.5”) Part # EPADLL

Matrx Lateral Trunk Support RIGHT pad (each) . . . .$108

Select Pad Size:

XS(3.25”x4.25”) Part # EPADXR S(3.5”x5.25”) Part # EPADSR

M(3.75”x5.75”) Part # EPADMR L(4.25”x6.5”) Part # EPADLR

SELECT SWING AWAY HARDWARE TO CONVERT ABOVE:

Matrx Elite Back Swing Away Hardware LEFT Part # SAHEBL . . . . . . . . . . . . . . . . . . . . . $195

RIGHT Part # SAHEBR . . . . . . . . . . . . . . . . . . . . $195

Matrx Offset Elite Swing Away Hardware LEFT Part # OSAHL . . . . . . . . . . . . . . . . . . . . . . $195

RIGHT Part # OSAHR . . . . . . . . . . . . . . . . . . . . . $195

Dealer Name: _______________________________________________


PO #:_______________________________________________________

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FIXED HIP/KNEE SUPPORTS

Lateral Hip Support Pad with Fixed Mounting LEFT .$120

Mounted at HIP Pad Size:XS(5.5”W x 4”H) Part # HSPXLH S(7”W x 6”H) Part # HSPSLH

M(9”W x 4”H) Part # HSPMLH L(13”W x 4”H) Part # HSPLLH

Mounted at KNEE Pad Size:XS(5.5”W x 4”H) Part # HSPXLK S(7”W x 6”H) Part # HSPSLK

M(9”W x 4”H) Part # HSPMLK L(13”W x 4”H) Part # HSPLLK

Lateral Hip Support Pad with Fixed Mounting RIGHT . . $120

Mounted at HIP Pad Size:XS(5.5”W x 4”H) Part # HSPXRH S(7”W x 6”H) Part # HSPSRH

M(9”W x 4”H) Part # HSPMRH L(13”W x 4”H) Part # HSPLRH

Mounted at KNEE Pad Size:XS(5.5”W x 4”H) Part # HSPXRK S(7”W x 6”H) Part # HSPSRK

M(9”W x 4”H) Part # HSPMRK L(13”W x 4”H) Part # HSPLRK

REMOVABLE & SWING AWAY HARDWARE UPGRADE

HARDWARE TO CONVERT ABOVE HIP SUPPORT TO UPGRADE TO REMOVEABLE/SWINGAWAY HIP OR KNEE SUPPORTS

Lift Off Removable Hardware for Hip Support (Hip position only)

LEFT Part # LOHL . . . . . . . . . . . . . . . . . . . . . .$195 RIGHT Part # LOHR . . . . . . . . . . . . . . . . . . . . . .$195

Swing Away Removable Hardware for Hip Supports

LEFT Mounted at Hip Part # SHSHLH . . . . . . . . .$215 RIGHT Mounted at Hip Part # SHSHRH . . . . . . . . .$215

LEFT Mounted at Knee Part # SHSHLK . . . . . . . .$215 RIGHT Mounted at Knee Part # SHSHRK . . . . . . . .$215

Maxx Style Quick Release, Removable, Multi-AxisMounting Hardware for Hip Supports

LEFT Mounted at Hip Part # MHSHLH . . . . . . . . .$215 RIGHT Mounted at Hip Part # MHSHRH . . . . . . . . .$215

LEFT Mounted at Knee Part # MHSHLK . . . . . . . .$215 RIGHT Mounted at Knee Part # MHSHRK . . . . . . . .$215

Extended Maxx Style Quick Release, Removable, Multi-AxisMounting Hardware for Hip Supports(1)

LEFT Mounted at Hip Part # EMQHLH . . . . . . . . .$215 RIGHT Mounted at Hip Part # EMQHRH . . . . . . . .$215

LEFT Mounted at Knee Part # EMQHLK . . . . . . . .$215 RIGHT Mounted at Knee Part # EMQHRK . . . . . . . .$215

NOTES: 1. Recomended when finished seat cushion thickness

will be greater then 3.5” high.

LEGREST RECEIVERS

Pride HD Drop-in Receivers Only Part # PHDR . . . . . . . . . . . STDPride Style #8 Swing Away Receivers Only Part # PSAR . . . . STDInvacare Action Receivers Only 70NHD Part # IAR . . . . . . . STDQuickie 70 Swing Away Receivers Only Part # Q70R . . . . . . STDQuickie 70HD Swing Away Receivers Only Part # Q70HDR . . . STDInvacare Hemi-Pin (PHW30) Receivers Only Part # IHPR . . . . STD

STANDARD FRONT RIGGINGFixed Center Mount Foot Platform(1) Part # FCMP . . . . . . . . N/C Comes with Rubber Coated Footplatform Part # IFP

Set at70° 90° 97°Part # SA70 SA90 SA97

Seat pan to footplate: 9”-13” Part # SPTF1Seat pan to footplate: 13”-17” Part # SPTF2

NOTES: 1. 3” ground clearance required.2. The front rigging will be set at approximatley 80° on the

Storm.

POWER CENTER MOUNT FOOT PLATFORM OPTIONS

LNX Power Center Mount Foot Platform(1) (2)

Part # LNX . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $3,20013”-19” unlimited adjustability

Short KTH option 10”-14” unlimited adjustability Part # LNXS . . . . N/C

Comes standard with a rubber coated footplate 11½” W x 10” Part # IFP

Comes standard with individual calf pads Part # ICP

Add: One Piece Malleable Calf Panel Part # OPCP . . . . . . . . .$250

Latitude Style Foot Platform Part # LSFP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $2,995 For Finished Knee to heel measurements of 6.5”-12”

Latitude Style Padded Foot PlatePart # LSPFP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$250

NOTES: 1. 3” of ground clearance required.2. The front rigging will be set at approximatley 80° on the Storm.

MUST BE COMPLETED Measurement in Inches

Knee to Heel:

Cushion Thickness: (Subtract)

Cushion Compression:(Add)

Seat Pan to Footplate:(Total)

Dealer Name: _______________________________________________


PO #:_______________________________________________________

Tag: _______________________________________________________


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MANUAL CENTER MOUNT FRONT RIGGING

Maxx Style Fixed Center Mount Foot Platform(1)(2)

Part # MSFCMFP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $395Comes standard with a rubber coated footplate 11½” W x 10” Part # IFP

Comes standard with individual calf pads Part # ICP

Set at70° 90°97°Part # SA70 SA90 SA97

Seat pan to footplate: 9”-13” Part # SPTF1Seat pan to footplate: 13”-17” Part # SPTF2

Invacare Center Mount Adjustable Knee Angle(1)(2)

Part # IAKACM (CTMT) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $595Seat pan to footboard: (9.25” - 12”) Part # SPTF3

(12.25” - 15”) Part # SPTF4 (5.25”Wx7.5”D) (5.5”Wx9.5”D)(5.9”Wx11.5”D) Footboard

Part # SM Part # MDM Part # LRG Part # FB

Invacare Calf Pads for use with CTMT Part # CALF . . . . . . . . . . . $268

NOTE: 1. 3” ground clearance required.2. The front rigging will be set at approximatley 80° on the Storm.

FOOT PLATFORM OPTIONS FOR MAXX/LNX CMFPSmall Flip-up Foot Platform(1) . . . . . . . $180 (12”W x 8.5”D) Part # SFFP

Medium Flip-up Foot Platform(1) . . . . . $180(12”W x 10.75”D) Part # MFFP

Large Flip-up Foot Platform(1) . . . . . . . $250 (14.5”W x 13”D) Part # LFFP

Extra Large Flip-up Foot Platform(1) . . $250(17”W x 13”D) Part # XLFFP

Extra, Extra Large Flip-up Foot Platform(1) . $250(21”W x 13”D) Part # XXLFFP

NOTE: 1. May cause interference with certain bases and seat widths call to confirm configuration.

INDIVIDUAL FOOT PLATE OPTIONS FOR MAXX/LNX CMFPIn cast aluminum with built in heel cups and rubber mat

Select:

Left:S(5”W x 7.5”D) M(5.5”Wx9.5”D)L(6”Wx11.5”D) $165

Part # IFSL IFML IFLL

Right: S(5”W x 7.5”D) M(5.5”Wx9.5”D)L(6”Wx11.5”D) $165Part # IFSR IFMR IFLR

POWER FRONT RIGGING OPTIONS (1)

Maxx Style Swing-Away Power Elevating Pivot Legrests(2) Part # MSPPL . . . . . . . . . . . . . . . . . . . . .$2,490

Select Receivers: Straight Flared outward 1”Part # RS Part # RF

Seat pan to footplate: S (10”-14”) M (13”-17”) L (16”-20”) Part # SPTF5 SPTF2 SPTF7

Select Function: Individual(3) Combined Synchronized W/Recline Part # INDA COMA SYNA

Calf pad options (Pair) . . . . . . . . . . . . . . . . . . . . . . . . .$275Select: Flat Pads Part # FCPMS

Curved Calf pads(4) (inside width is 6”) Part # CCPMSNOTES:

1. Comes standard with moulded i-skin calf pads.2. Includes Swing Away receivers, Pivot Plus Legrests and

actuators. Legs swing away manually.3. Individual legs count as two functions.4. Not available on 14” and 15” seat widths. For 16” and 17” seat

widths you must select flared receivers.

Select Footplates on page 11 under Foot plate options

MANUAL FRONT RIGGING OPTIONS (1)

Maxx Style Swing-Away Manual Elevating Pivot Legrests Part # MMPPSA . . . . . . . . . . . . . . . . . . . . . . $680

Select Receivers: Straight Flared outward 1”Part # RS Part # RF

Seat pan to footplate: S (10”-14”) M (13”-17”) L (16”-20”)Part # SPTF5 SPTF2 SPTF7

Calf pad options (Pair) . . . . . . . . . . . . . . . . . . . . . . . . .$275Select: Flat Pads Part # FCPMS

Curved Calf pads(2) (inside width is 6”) Part # CCPMSNOTE:

1. Comes standard with moulded i-skin calf pads.2. Not available on 14” and 15” seat widths. For 16” and 17” seat


Select Footplates on page 11 under Foot plate options:

SWING AWAY FRONT RIGGING OPTIONSHeavy Duty 70° Swing away Footrests(1) (Pair) Part # HD70 . . .$495

Select Receivers: Straight Flared outward1”

Part # RS Part # RFSeat pan to footplate:

XS (6”-11”) S (11”-15”) M (13”-17”)L (16”-20”) Part # SPTF11 SPTF8 SPTF2 SPTF7

Calf pads for HD Swing Away Footrests (Pair) . . . . . . . . $275Select: Flat Pads Part # HD70FCP

Curved Calf pads(2) (inside width is 6”) Part # HD70CCP

Dynamic Coil Springs (Pair) for Heavy Duty 70° Swingaway Footrests Part # DCS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$190

Invacare 70° Swingaway Footrests (Pair) Part # I70SAF . . .$325Comes with composite foot plates Part # I70-CF

NOTES: 1. Heavy duty durable construction (4.5lbs ea.).2. Not available on 14” and 15” seat widths. For 16” and 17” seat


Dealer Name: _______________________________________________


PO #:_______________________________________________________

Tag: _______________________________________________________


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SWING AWAY FRONT RIGGING OPTIONS

Invacare 70° Non-Tapered HD Swingaway Footrests withAT5543 Adjustable Angle Foot plates, Heel Loops andImpact Guards (Pair)Part # 70HDAIH . . . . . . . . . . . . . . . $457

Invacare Tapered 70° Swingaway Footrests with AT5543Adjustable Angle Footplates, Heel Loops and Impact Guards(Pair)(1) Part # 70HTAPAIH . . . . . . . . . . . . . . . . . . . . . . $497

Longer Pivot and Slide Tube for 70° Swingaways (Pair)Part # ALPT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $132

Residual Limb Support(1) (Each) (6.75”W x 9.75”L x 2”H) . . . . . . .$495Select: Left Part # RLSL Right Part # RLSR

NOTES: 1. Swing away and removable, 50° of angle adjustment,

3.5” height adjustment and 2” of for/aft adjustment.

FOOT PLATE OPTIONS FOR ELEVATING &SWING AWAY FRONT RIGGING (1)

Adjustable Angle Foot Plates (each) . . . . . . . . . . . . . . $165

LEFT S(4.25”W x 8”D) M(5.25”Wx8”D) L(6.25”Wx8”D) XL(9”Wx11”D)Part # AFSL AFML AFLL AFXL

RIGHT S(4.25”W x 8”D) M(5.25”Wx8”D) L(6.25”Wx8”D) XL(9”Wx11”D)Part # AFSR AFMR AFLR AFXR

Multi-Axis Adjustable Angle Foot Plates(each) . . . . . $225LEFT S(4.25”W x 8”D) M(5.25”Wx8”D) L(6.25”Wx8”D) XL(9”Wx11”D)Part # MFSL MFML MFLL MFXL

RIGHT S(4.25”W x 8”D) M(5.25”Wx8”D) L(6.25”Wx8”D) XL(9”Wx11”D)Part # MFSR MFMR MFLR MFXR

Adjustable Angle Foot Plates with Caster Cut (each) $165LEFT S(7.25”W x 9”D) M(7.5”W x 11”D) L(10”W x 14”D)

Part # AFCSL AFCML AFCLL

RIGHT S(7.25”W x 9”D) M(7.5”W x 11”D) L(10”W x 14”D)Part # AFCSR AFCMR AFCLR

Multi-Axis Adjustable Angle Foot Plates Caster Cut(each) $225LEFT S(7.25”W x 9”D) M(7.5”W x 11”D) L(10”W x 14”D)

Part # MFCSL MFCML MFCLL

RIGHT S(7.25”W x 9”D) M(7.5”W x 11”D) L(10”W x 14”D)Part # MFCSR MFCMR MFCLR

Heel Loops (each) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $20 Left Part # HLLRight Part # HLR

NOTE: 1. Certain footplate sizes may not fit all seat widths depending on

legrests selected. Call for confirmation if necessary.

CALF PANEL & STRAP OPTIONS(1)

Airmesh Calf Strap for chairs 15”-18”W - 3.5”H pad height Part # CSM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $115

Airmesh Calf Strap for chairs 18”-22”W - 3.5”H pad height Part # CSL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $115

Airmesh Calf Panel for chairs 15”-18”W;

35.5”W x 9”H pad Part # CPM . . . . . . . . . . . . . . . . . . . $170

Airmesh Calf Panel for chairs 18”-22”W;

38.5”W x 9”H pad Part # CPL . . . . . . . . . . . . . . . . . . . $185

NOTE: 1. Not available for Center Mounted Front Rigging.

SINGLE-FUNCTION ELECTRONICS

Select: LeftRightDo Not MountSpecialty Controls*Part # ESML ESMR ESMD ESMS

SINGLE-FUNCTION ELECTRONICS

Single Function Control Box(1)

Part # SFCB . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . STD

Single Function Drive with Attendant Control(1)(2)

Part # SFCBA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$750

Please Select Method of Operation:

Single Push Button Part # SPBO

Single Toggle Part # STO

Dual Push Button Part # DPBO

Omit Switch Part # OSO

Through Joystick Part # JOY

Through Specialty Control* Part # SC

Add: Reduced Drive for Elevating Seat(3) Part # RDE . . . . . . $400

Additional Switch: Single Push Button Part # SPBSA . . . . . . $97 Single Toggle Part # STA . . . . . . . . . . . .$97 Dual Push Button Part # DPBA . . . . . . . . .$97NOTES:

1. These electronics include drive lock-out and tilt limit.2. Comes with an attendant control for programming.3. If reduced drive is not selected system will be in drive lock-out

when elevated.

F

Dealer Name: _______________________________________________


PO #:_______________________________________________________

Tag: _______________________________________________________


MED bilitym



MULTI-FUNCTION ELECTRONICS

Multi Function Control Box - Switches/Toggles(1)

Part # MFCBS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $1,950Select: Quad Push Button Part # QPB

Four-Way Toggle Part # FWT

8-Way Rocker(2) Part # EWR

Add: Reduced Drive for Elevating Seat (3) Part # RDE . . . . . . . . .$400

Multi Function Through Drive Control(1)

Part # MFCBD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $1,950

Through Joystick Part # JOY

Through Specialty Control* Part # SC

*Please contact Customer Service for a specialty control configuration sheet.

Includes:Reduced Drive for Elevating Seat Yes Part # RDY

No(3) Part # RDN Additional Switch: Quad Push Button Part # QPBA ..................$97 Four-Way Toggle Part # FWTA ...................$97 8-Way Rocker(2) Part # EWRA ..................$150NOTES:

1. These electronics include attendant control, drive lock-out,tilt/recline limit and actuator speed control.

2. Dual function is not available with 8-Way Rocker.3. If reduced drive is not selected system will be in drive lock-out when elevated.

ELECTRONICS OPTIONS

M616 Converter (1) Part # M616S. . . . . . . . . . . . . . . $125(Allows for multiple switch options with phono plug connection)

Feather Touch Switch - Single function . . . . . . . . . . . . . . . . .$97Dime Size Part # FTSD Quarter Size Part # FTSQ

Feather Touch Switch - Multi function . . . . . . . . . . . . . . .$135Dual Dime Size Part # FTMD Quad Dime Size Part # FTMQ

Stealth Egg Switch - Single function . . . . . . . . . . . . . . .$77 Green Part # SESG Black Part # SESB

Power Shut Off Switch -Toggle Switch Only (1)

HCPCS code E2399 Part # PSOS . . . . . . . . . . . . . . . . . . . . . . .$175

Lazarus Jump Starter (1) Part # LJS . . . . . . . . . . . . . . .$150HCPCS code A9270

Accessory Port Power Supply(1)(3 amp capacity) Part # APPS .$195

12 Piece Switch Mounting Hardware Kit Part # TPSMH . .$39(additional kits)

NOTE: 1. Not available with the Standard Electronics option.

VENT TRAYS(1)(2)(3)

Vent Tray - Articulating (Without battery tray) . $1,350

Horizontal (14W x 15D x 10H) Part # ARTVTHVertical (14.625W x 10.125D x 13H) Part # ARTVTV

Vent Tray - Trilogy 100/200 (14W x 6D) Part # TRILVT $1,350NOTES:

1. The user weight limit is 225 lbs.2. The maximum weight capacity of the vent tray is 35 lbs.3. Vents are not standard configuration on Elevating or Precline

Systems or with Single Post Backs.

COMPACT-LAPTOP VENT TRAYS(1)(2)(3)

Vent Tray Part # CVT . . . . . . . . . . . . . . . . . . . . . $1,350

Vent Bag Holder - Articulating Part # VBHA . . . . . . . . $990

Vent Bag Holder - Non-Articulating Part # VBHNA . . . $525NOTES:

1. The user weight limit is 225 lbs.2. The maximum weight capacity of the vent tray is 35 lbs.3. Vents are not standard configuration on Elevating or Precline

Systems or with Single Post Backs.

O2 HOLDERS(1)(2)(3)

Non-Articulating O2 Gas Holder Part # NAO2H . . . . . . . . . $395(Cylinder Style)

Articulating O2 Gas Holder . . . . . . . . . . . . . . . . . . . $1,250

Select:

O2 Gas (Cylinder Style) Part # AOHGLiquid O2 (6.5” x 4.5”) Part # AOHL

Non-Articuating IV Pole . . . . . . . . . . . . . . . . . . . . . . . $395

Users Left Part # NAIPL Users Right Part # NAIPR

Articuating IV Pole Part # AIVP . . . . . . . . . . . . . . . . . . .$1,250NOTES: 1. Articulating O2 holders are not standard configurations on

Precline System, please call for quotation.2. Client weight capacity is 225 lbs when using an O2 holder.3. The weight capacity of the O2 holder is 20 lbs.

Dealer Name: _______________________________________________


PO #:_______________________________________________________

Tag: _______________________________________________________For your ASL Drive Systems needs please refer to the

following order form 18-395C.


MED bilitym



ADDITIONAL OPTIONS & ACCESSORIES

Concepts Back Pack Single Part # SBP . . . . . . . . . . . . . $125Double Part # DBP . . . . . . . . . . . . $195

Transfer Handles (Height Adjustable) . . . . . . . . . . . . . . . . . $350 Select: 4”-6.5” Part # THS 9”-11.5” Part # THL

Push Handles for Recline Systems (1) . . . . . . . . . . . . . . $350 Select: Straight Part # RPHS Angled Part # RPHA

D-Loops (set of 2)(2) Part # DL00P . . . . . . . . . . . . . . . . . . $250

Flip & Fold Away 1/2 Lap Tray(3) (14”W x 10”D) . . . . . . $795

Select Mounting:Left Part # FFLTL Right Part # FFLTR

NOTES: 1. 4” of total vertical mounting adjustment.2. May increase seat to floor heights by approximately 3/8”.3. Not available on joystick side and only available with a flat

arm pad or modular arm pad. Not available on OutbackCantilever Recline Armrests.

INSTALLATION Installation by Motion Concepts(1) Part # MCI . . . . . . . . . N/C

NOTE: 1. Batteries may be required if items on Accessories order form are

selected at time of installation, please call to confirm.

Total Retail Value $

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Dealer Name: _______________________________________________


PO #:_______________________________________________________

Tag: _______________________________________________________


form 16-950c storm torque sp order form february 15 2019...lc1720 lc1816 lc1818 lc1820 lc1916 lc1918...

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