frame - ki mobilityethos k0005, e1235 _____ $2995 ethos standard frame. 275 lb weight capacity. this...
TRANSCRIPT
Phone (800) 981-1540 | Fax (715) [email protected] | www.kimobility.com
Effective 02/17/2020
Company: ________________________________________________
Account Number: __________________ Date: _________________
q Quote q PO Number: ___________________________________
RTS: _____________________________________________________
Marked For: _______________________________________________
Ship To: __________________________________________________
Address: _________________________________________________
City: ________________________________ State: _____________
Zip: ________________ Phone: _____________________________
Email/Fax: ________________________________________________
HCPCS codes provided are based on code verification by the PDAC or our interpretation of the code definitions.
Proper use of HCPCS codes does not ensure coverage or payment. For coverage information, verify the appropriate payerβs coverage policy.
Frame
Seat Width / Seat DepthSelect box corresponding to desired Seat Width and Depth.See references A and B on page 8.
Seat Width
12β 13β 14β 15β 16β 17β 18β 19β 20β
PriceHCPCS
N/C N/C N/C N/C N/C N/C N/C N/C$500E2201
Sea
t D
epth
14β N/C q q q q q q q q q15β N/C q q q q q q q q q16β N/C q q q q q q q q q17β N/C q q q q q q q q q18β N/C q q q q q q q q q19β N/C q q q q q q q q q20β $500
E2203 q q q q q q q q q
Transit Option
Sling PositionIn Performance Position (0β), sling is at front of frame. The 1β or 2β sling position extends the frame in front of the sling by that amount. See reference C on page 8.
q 0β (Performance) ________________________________________________________________________________ N/Cq 1β _____________________________________________________________________________________________________________ N/Cq 2β (Classic) ___________________________________________________________________________________________ N/C
Adjustable DepthAdds the capability to grow seat in depth
q No Rear Adjustment _________________________________________________________________________ N/Cq 1/2β _________________________________________________________________________________________________________ N/Cq 1β ___________________________________________________________________________________________________________ $165q 1 1/2β ___________________________________________________________________________________________________ $165q 2β ___________________________________________________________________________________________________________ $165
Front Frame BendAngle between front seat tube and ground. See reference D on page 8.
q 90ΒΊ __________________________________________________________________________________________________________ N/Cq 85ΒΊ __________________________________________________________________________________________________________ N/Cq 80ΒΊ __________________________________________________________________________________________________________ N/Cq 75ΒΊ __________________________________________________________________________________________________________ N/Cq 70ΒΊ __________________________________________________________________________________________________________ N/C
Cannot be retrofitted
q Transit System __________________________________________________________________________________ $320
DCN0384.4 Pricing and specifications subject to change without notice Page 1 of 8
Ethos K0005, E1235 ______________________________________________________________________ $2995Ethos Standard Frame. 275 lb weight capacity.
This form must be opened in Adobe Acrobat. The Submit Form button will not work from most browser windows.
Polymer Setup
Polymer Gauge and Recommended Max Weight Capacity
Ultra Soft (Red) Soft (Blue) Mid (Black) Rigid (Green)
(<120 lbs) (<150 lbs) (<250 lbs) (<275 lbs)
Front ISO Tower q q q qRear ISO Tower q q q q
Setup determines characteristics of ride experience. For more information visit www.kimobility.com. If no selection is made Standard Setup will be used. Every chair includes one stage up and one stage down from what is assembled at time of build. Refer to the ISO TECH Setup Guide for more information.
Setup by Ki __________________________________________________________________________________________________ StdA series of intelligent calculations using data below and chair configuration to determine optimal polymer setup based on desired ride experience
User Weight Range (lbs) q 120 or less q 121-165 q 166-209 q 210-275
Ride Experience q Firmer q Softer
q Standard Setup __________________________________________________________________________________ N/CPolymer configuration calculated by chair size. No additional information required.
q Custom Setup _____________________________________________________________________________________ N/CSelect from chart below
Seat Pan
q Solid Seat Pan E2231 ______________________________________________________________________ $265
Select if chair quote has: q Additional Ki Products with Different Quote/Order Number Quote/Order Number: ____________________
Rigidizer Bar
q Adjustable Height Rigidizer Bar _____________________________________________________ $75
Seat Back AngleStandard is 90ΒΊ (perpendicular to floor). Minus (-ΒΊ) closes back angle. Plus (+ΒΊ) opens back angle.
q Standard q +3ΒΊ q +6ΒΊ q +9ΒΊq -3ΒΊ q -6ΒΊ q -9ΒΊ q -12ΒΊ
Military Patch
Back Upholstery
Phone (800) 981-1540 | Fax (715) 254-0996
[email protected] | www.kimobility.com
DCN0384.4 Pricing and specifications subject to change without notice Page 2 of 8
Backrest
Push Handle
q Omit Push Handle _____________________________________________________________________________ N/Cq Standard Push Handle _____________________________________________________________________ N/Cq Low Profile Push Handle _______________________________________________________________ $135
2β shorter than standard push handles
q Fold Down Push Handle ________________________________________________________________ $100 q Bolt-On Push Handle ______________________________________________________________________ $175
Handles will be 1β - 2β above back height
Stroller HandleStroller Handles are removable and height adjustable
q Single Stroller Handle _____________________________________________________________________ $165q Double Stroller Handle ___________________________________________________________________ $330
Not available with Push Handles
Back Post / Height Range / Back HeightSelect Back Height in row corresponding to desired Back Post and Height Range.
BackPost
Price Height Range
Back Height
Height Adjustable
N/C
Short q 112 q 12 q 13 q 14
Medium q 13 q 14 q 15 q 16 q 17
Tall q 17 q 18 q 19 q 20
FixedHeight 1
N/Cq 92 q 102 q 112 q 12 q 13
q 14 q 15 q 16 q 17 q 181 Not available with back upholstery2 Not available with Fold Down Push Handle
If selecting both upholstery and Axiom Back, the upholstery will be installed
Padded Velcro Adjustable q Standard Cover ______________________________ Std q Air Mesh Breathable Cover ______________________ $75
Tension Adjustable E2611
q Standard Cover _____________________________ $300 q Air Mesh Breathable Cover ____________________ $375
q Omit Back Upholstery _____________________________________________________________________ -$10
US Military Service Patch _______________________________________________________________________ $90 q Army q Navy q Marines q Air Force q Coast Guard
q US Purple Heart Patch _____________________________________________________________________ $90
Purple Heart with Military Service Patch Combo __________________________ $145 q Army q Navy q Marines q Air Force q Coast Guard
Front Seat Height and Casters
Caster Type
Caster Size / Footrest Taper / Front Seat Height
Fork Options
q Standard Fork ______________________________________________________________________________________ Stdq Single Sided Fork _____________________________________________________________________________ $125q Frog Legs Ultra-Sport Fork - Black E1015 ________________________________ $425
Not included in Colored Anodizing Package
End User Weight Required: ____________ lbsq Frog Legs PHASE 2 Carbon Fork ______________________________________________ $425
Lightweight shock absorbing fork. Not included in Colored Anodizing Package.
Select Front Seat Height in row corresponding to Footrest Taper and Caster Size. 6β casters not available with 85ΒΊ and 90ΒΊ Front Frame Bend.
Footrest Taper indicates bend of front frame creating footrest width. 2β Taper not available with seat widths less than 16β. V-Front not available with seat widths less than 14β. V-Front results in 4β reduction from seat width to footrest width. Taper is measured from outside of seat frame to outside of front tube. See reference E on page 8.
Front Seat Height is measured from floor to top of seat tube at front of seat sling. Minimum adjustment is +/- 1/2β. See reference F on page 8.
FootrestTaper
Price Caster Size
Front Seat Height
Straight N/C
3β q13.5 q 14 q14.5 q 15 q15.5 q 16 q16.5 q 17 q17.5 q 18 q18.5 q 19 q19.5 q 20 q20.5
4β q 14 q14.5 q 15 q15.5 q 16 q16.5 q 17 q17.5 q 18 q18.5 q 19 q19.5 q 20 q20.5
5β q14.5 q 15 q15.5 q 16 q16.5 q 17 q17.5 q 18 q18.5 q 19 q19.5 q 20 q20.5
6β q 15 q15.5 q 16 q16.5 q 17 q17.5 q 18 q18.5 q 19 q19.5 q 20 q20.5
1β Taper N/C
3β q16.5 q 17 q17.5 q 18 q18.5 q 19 q19.5 q 20 q20.5
4β q 17 q17.5 q 18 q18.5 q 19 q19.5 q 20 q20.5
5β q17.5 q 18 q18.5 q 19 q19.5 q 20 q20.5
6β q 18 q18.5 q 19 q19.5 q 20 q20.5
2β Taper N/C
3β q16.5 q 17 q17.5 q 18 q18.5 q 19 q19.5 q 20 q20.5
4β q 17 q17.5 q 18 q18.5 q 19 q19.5 q 20 q20.5
5β q17.5 q 18 q18.5 q 19 q19.5 q 20 q20.5
6β q 18 q18.5 q 19 q19.5 q 20 q20.5
V-Front $350
3β q16.5 q 17 q17.5 q 18 q18.5 q 19 q19.5 q 20 q20.5
4β q 17 q17.5 q 18 q18.5 q 19 q19.5 q 20 q20.5
5β q17.5 q 18 q18.5 q 19 q19.5 q 20 q20.5
6β q 18 q18.5 q 19 q19.5 q 20 q20.5
q .75β Rollerblade __________________________________________________________________________________ N/CAvailable only with 3β and 4β Caster Sizes
q .75β Lighted Rollerblade __________________________________________________________________ $70Available only with 3β and 4β Caster Sizes
q 1β Poly ___________________________________________________________________________________________________ N/CNot available with 3β Caster Size
q 1β Poly Aluminum _____________________________________________________________________________ $110Available only with 4β and 5β Caster Sizes
q 1β Pneumatic _______________________________________________________________________________________ $85Available only with 6β Caster Size
q 1.5β Poly _______________________________________________________________________________________________ $50Not available with 3β Caster Size
q 1.5β Soft Roll Aluminum _________________________________________________________________ $175
Phone (800) 981-1540 | Fax (715) 254-0996
[email protected] | www.kimobility.com
DCN0384.4 Pricing and specifications subject to change without notice Page 3 of 8
q Optimized ______________________________________________________________________________________________ StdCaster placement relative to seat frame has been set to maximize adjustability and minimize the footprint of the chair
q Expanded Width ________________________________________________________________________________ N/CCaster arm is positioned approximately .75β wider than Optimized position
Caster Position
Footrest
Seat to Footrest LengthFootplate
q Tubular βOpenβ Footplate _________________________________________________________________ StdNot available with V-Front Taper
q Tubular Footplate with ABS Cover _______________________________________________ $30Not available with V-Front Taper or footrest widths greater than 15.5β. See Reference G on page 8.
q Aluminum Angle Adjustable K0040 _______________________________________________ $95Not available with V-Front Taper
q Hybrid Angle Adjustable K0040 ______________________________________________________ $95q Hybrid Angle Adjustable with Wings K0040 ______________________________ $125
Raised sides aid in foot positioning
q Angle Adjustable Flip Under K0040, K0037 _________________________________ $185Not available with V-Front Taper. Available only with 9.5β-15.5β footrest width. See Reference G on page 8.
Rear Seat Height and Wheels
Wheel Size / Rear Seat Height
Rear Wheel Type
q MAXX Performance Spoke _____________________________________________________________ N/Cq Mag ________________________________________________________________________________________________________ N/C
Not available in 25β or 26β wheel sizes
q Superlight Spoke _____________________________________________________________________________ $315Available only in 24β and 25β wheel sizes. 25β wheel size available only with Superlight and Plastic Coated Handrims.
Spinergy Spox _________________________________________________________________________________________ $820 Color: q Black q Red q White q Blue q Yellow
Handrim: q Short Tab q Long TabAvailable only with Aluminum Anodized and Plastic Coated Handrims
Spinergy LX ___________________________________________________________________________________________ $1025 Color: q Black q Red q White q Blue q Yellow
q Pink q Green q Orange q Purple
Handrim: q Short Tab q Long TabAvailable only with Aluminum Anodized and Plastic Coated Handrims
q Omit Rear Wheel and Tire ______________________________________________________________ -$45No axles will be provided
Select Rear Seat Height in row corresponding to desired Wheel Size. For proper setup, selection is required when omitting rear wheels.Measured from floor to top of seat tube at front of back post. Rear Seat Height is custom to needs. See reference I on page 8.
Wheel Size Rear Seat Height
22β q 13.5 q 14 q 14.5 q 15 q 15.5 q 16 q 16.5 q 17 q 17.5 q 18 q 18.5 q 19 q 19.5 q 20
24β q 14.5 q 15 q 15.5 q 16 q 16.5 q 17 q 17.5 q 18 q 18.5 q 19 q 19.5 q 20
25β q 14.5 q 15 q 15.5 q 16 q 16.5 q 17 q 17.5 q 18 q 18.5 q 19 q 19.5 q 20
26β q 15.5 q 16 q 16.5 q 17 q 17.5 q 18 q 18.5 q 19 q 19.5 q 20
Rear Tire Type
q Street Pneumatic 1 3/8β E2211, E2212 ___________________________________________ StdNot available on 25β wheel size
q Full Poly 1 3/8β E2218 _______________________________________________________________________ N/CNot available on Superlight wheel or 25β or 26β wheel sizes
q Pneumatic with Airless Insert 1 3/8β E2211, E2213 ____________________ $95Not available on Superlight wheel or 25β wheel size
q Schwalbe HS-127 1 3/8β E2211, E2212 ______________________________________ $125Available only on 24β wheel size. Not available on Mag wheel.
q Euro Trek Knobby 1 3/8β E2211, E2212 _________________________________________ $95Available only on 24β wheel size
q Mountain 2β Black E2211, E2212 _____________________________________________________ $95Available only on 22β, 24β and 25β MAXX Performance and Spinergy wheels
q Low Poly 1β E2218 _____________________________________________________________________________ $75Not available on Superlight wheel, 25β or 26β wheel sizes
q Sentinel Solid Tire 1β E2218 ____________________________________________________________ $95Not available on Superlight wheel or 22β Mag wheel
q High Pressure 1β E2211, E2212 ________________________________________________________ $95Not available on Mag wheel
q Schwalbe One 1β E2211, E2212 ____________________________________________________ $135Available only on 24β and 25β wheel sizes. Not available on Mag wheel.
q Schwalbe Marathon Plus Evolution 1β E2211, E2212 ______________ $135Not available on Mag wheel or 22β wheel size
Full Profile
Low Profile
Phone (800) 981-1540 | Fax (715) 254-0996
[email protected] | www.kimobility.com
DCN0384.4 Pricing and specifications subject to change without notice Page 4 of 8
q Footrest Protector _____________________________________________________________________________ N/CNot available with Angle Adjustable Flip Under Footplate
Footrest Protector
Measured from front edge of seat sling to top, rear of footrest. Footrest length at least 2.5β shorter than Front Seat Height recommended. See reference H on page 8.
Taper Seat to Footrest Length
Straight and V-Front
q 9β q 9.5β q 10β q10.5β q 11β q11.5β
q 12β q12.5β q 13β q13.5β q 14β q14.5β
q 15β q15.5β q 16β q16.5β q 17β q17.5β
q 18β q18.5β q 19β q19.5β
1β Taper and 2β Taper
q13.5β q 14β q14.5β q 15β q15.5β q 16β
q16.5β q 17β q17.5β q 18β q18.5β q 19β
q19.5β
Handrim Axle
q Quick Release ______________________________________________________________________________________ Stdq Quad Quick Release _______________________________________________________________________ $185
Not available with Mag or Spinergy wheels
Rear Wheel SpacingMeasured from outside of back to inside of rear tire. 1.75β minimum Rear Wheel Spacing with Height Adjustable Armrests. 1β minimum Rear Wheel Spacing with side guards. See reference K on page 8.
q .75β q 1β q 1.25β q 1.5β q 1.75β
Rear Wheel Camber
q 0ΒΊ q 2ΒΊ q 4ΒΊ q 6ΒΊ q 8ΒΊ
Handrim Option
q 3M Micro Grip _____________________________________________________________________________________ $65Not available on Plastic Coated or Projection Handrims
Rear Seat Height and Wheels continued
Wheel Locks
Wheel Lock Wheel Lock Options
q Push to Lock ________________________________________________________________________________________ Stdq Push to Lock Flush Mount ______________________________________________________________ N/C
Not available with Mountain tires
q Pull to Lock ___________________________________________________________________________________________ Stdq Low Profile Scissor Lock _________________________________________________________________ $45
Not available with Low Poly, Full Poly or Sentinel Solid tires
q Short Thro Scissor Lock ________________________________________________________________ $125q Omit Wheel Locks _____________________________________________________________________________ N/C
q Aluminum Anodized ___________________________________________________________________________ Stdq Superlight Aluminum Anodized _____________________________________________________ $50
Available only on 24β and 25β wheel sizes. Available only on MAXX Performance, Superlight or Spinergy wheels.
q Plastic Coated _____________________________________________________________________________________ $95q Projection (8 Vertical Projections) ________________________________________________ $315
Available only with full profile tires in combination with MAXX Performance, or 24β Mag wheel
q Spinergy Flex Rim ____________________________________________________________________________ $650Available only on 24β and 25β Spinergy LX wheels
q Omit Handrim ______________________________________________________________________________________ N/C
Not available on 22β Mag wheel. Not recommended with Mag wheel.
q Natural Fit LT Regular Grip ____________________________________________________________ $465q Natural Fit Standard Regular Grip _______________________________________________ $445q Natural Fit LT Super Grip _______________________________________________________________ $515q Natural Fit Standard Super Grip __________________________________________________ $495q Natural Fit LT Omit Grip _________________________________________________________________ $395q Natural Fit Standard Omit Grip ____________________________________________________ $375
Natural Fit Handrims
q Extension Handles E0961 ________________________________________________________________ $70Available only with Push to Lock or Pull to Lock Wheel Locks
q Grade Aids E0974 _____________________________________________________________________________ $150Available only with Push to Lock Wheel Locks and Pneumatic or Pneumatic with Airless Insert tires
Standard Handrims
Phone (800) 981-1540 | Fax (715) 254-0996
[email protected] | www.kimobility.com
DCN0384.4 Pricing and specifications subject to change without notice Page 5 of 8
Amputee Positions
Standard Positions
Center of Gravity Setup
q -1.5β q -1.25β q -1β q -.75β q -.5β q -.25β
q 0β q .25β q .5β q .75β q 1β q 1.25β
q 1.5β q 1.75β q 2β q 2.25β q 2.5β q 2.75β
q 3β q 3.25β q 3.5β q 3.75β q 4β q 4.25β
Measured from front of back post to center of rear axle. 0β indicates axle will be directly under back post. See reference J on page 8.
Accessories
Positioning Belt
q 1 1/2β Auto Buckle E0978 ________________________________________________________________ $70q 1 1/2β Padded Auto Buckle E0978 _____________________________________________ $155q 1β Auto Buckle E0978 _______________________________________________________________________ $70q 1β Padded Auto Buckle E0978 _____________________________________________________ $155q 2β Airline Buckle E0978 ___________________________________________________________________ $110
Bodypoint Evoflex - Pelvic Stabilizer E0978 ____________________________________ $183 Size: q Small (16-24β) q Medium (19-29β) q Large (25-37β)
Other Accessories
q Tool Kit ___________________________________________________________________________________________________ $45q Removable Underseat Pouch ________________________________________________________ $50q Ki Mobility Backpack ________________________________________________________________________ $65q Luggage Carrier _________________________________________________________________________________ $85q Under Chair Carrier and Removable Bag ___________________________________ $85
Not available with Seat Widths less than 14β
q Clear Spoke Guards K0065 ___________________________________________________________ $115Not available with Mag wheel
q Black Spoke Guards K0065 __________________________________________________________ $115Not available with Mag wheel
Calf Strap
Phone (800) 981-1540 | Fax (715) 254-0996
[email protected] | www.kimobility.com
Side Guards
Fabric Side GuardNot available when omitting Back Upholstery
q Fabric Side Guards K0108 _______________________________________________________________ $85
Belt Mounting Kit
q Ki Mobility Belt Mounting Clamp ___________________________________________________ $35
q Composite Side Guards K0108 ____________________________________________________ $145
Aluminum Straight K0108
q Black Matte _________________________________ $225 q Match Seat Frame Color ______________________ $275
Not available with Hydrographics
q Match Base Frame Color ______________________ $275
Aluminum Adjustable Fender K0108
q Black Matte _________________________________ $305 q Match Seat Frame Color ______________________ $355
Not available with Hydrographics
q Match Base Frame Color ______________________ $355
q Carbon Fiber Adjustable Fender K0108 _____________________________________ $515
Clamp-On Mount
DCN0384.4 Pricing and specifications subject to change without notice Page 6 of 8
Armrests
Armrest Please select Arm Pad option
q Height Adjustable T-Arm (8.5β - 13.5β) E0973 ________________________________ $340
Arm Pad
Armrest continued
Not available with Swing Away Armrests
q Desk q Full
Not available with Height Adjustable T-Arm or Swing Away with Side Guard Armrests
Anti-Tip
q Rear Anti-Tips E0971 _______________________________________________________________________ $140
User Activated E0971
q Pair ________________________________________ $330 q Single - Left _________________________________ $165 q Single - Right _______________________________ $165
Swing Away E0973Not available with Arm Pads. Certain configurations may dictate selection.
q Short (8.5β - 10.5β) _____________________________ $195 q Tall (10.5β - 12.5β) _______________________________ $195
Swing Away with Side Guard E0973Includes Composite Side Guards. Not available with Arm Pads. Certain configurations may dictate selection.
q Short (8.5β - 10.5β) _____________________________ $285 q Tall (10.5β - 12.5β) _______________________________ $285
q Omit Armrests _____________________________________________________________________________________ N/C
Mounting hardware included with Calf Straps
q Velcro Adjustable K0038 ___________________________________________________________________ $40q Padded Velcro Adjustable K0038 __________________________________________________ $68q Bodypoint Padded AeroMesh K0038 _________________________________________ $102q Calf Strap Mounting Hardware (Extra) _________________________________________ $25
Phone (800) 981-1540 | Fax (715) 254-0996
[email protected] | www.kimobility.com
DCN0384.4 Pricing and specifications subject to change without notice Page 7 of 8
Color
Paint OptionsIf there is no color preference Black is recommended
Options Price
ColorsGloss Matte
Hydrographics 1 $695Visit www.kimobility.com for current Hydrographic options. Note selection below.B
lack
Blu
e S
kies
Bub
ble
gum
Pin
k
Can
dy
Blu
e
Can
dy
Pur
ple
Can
dy
Red
Cop
per
Gra
nny
Sm
ith
Met
allic
Fuc
hsia
Met
allic
Ora
nge
Silv
er
Teal
Yello
w
Cha
rcoa
l Gra
y
Em
eral
d G
reen
Irid
esce
nt B
urgu
ndy
Irid
esce
nt N
avy
Milit
ary
Gre
en
Ret
ro R
ed
Roy
al B
lue
Sha
dow
Bla
ck
Sm
ooth
Whi
te
Seat Frame N/C q q q q q q q q q q q q q q q q q q q q q q Color: _____________________________
Base Frame 2 N/C q q q q q q q q q q q q q q q q q q q q q q
BackrestRelease Bar
Std q Black Anodized$25 q Paint to Match Seat Frame$25 q Paint to Match Base Frame
$50 q Paint Other ColorSelect option below
q q q q q q q q q q q q q q q q q q q q q q1 Not available with Transit Option2 Not available with Hydrographics
Additional Color Options
Color Reference
A Seat Frame
B Base Frame
C Highlights
A
B C
C
C
If no selection is made, black will be used
Options Price
Colors
Bla
ckB
lue
Gra
yG
reen
Ora
nge
Pin
kP
urp
leR
edYe
llow
Bla
ckB
lue
Brig
ht G
reen
Gol
dO
rang
eP
ewte
rP
ink
Pur
ple
Red
HighlightsDiscreet color highlights. See image below for parts included.
N/C q q q q q q q q q
Colored Anodizing
Back Plate 1Black: N/C Color: $75 q q q q q q q q q
Caster Fork 2Black: N/C Color: $75 q q q q q q q q q
Side Guard Receiver Black: N/C Color: $75 q q q q q q q q q
Camber Tube Black: N/C Color: $75 q q q q q q q q q
1 Not available with Transit Option2 Available only with Standard or Single Sided
References A. Seat Width See Diagram 1
Measured from outside of frame tube on one side to outside of frame tube on other side.
B. Seat Depth See Diagram 3
Measured from front of back posts to front edge of seat sling. Seat sling starts at beginning of bend at front of frame.
C. Sling Position See Diagram 2
In Performance Position (0β), sling is at front of frame to keep chair shorter and more maneuverable. The 1β or 2β seat sling position extends the frame in front of the sling by that amount. Adding more frame can improve stability and provide support to aid in transfers.
D. Front Frame Bend See Diagram 3
Angle between front seat tube and ground.
Seat Width Straight 1β Taper 2β Taper V-FrontOutside
Measurement2β Narrower
than Seat Width4β Narrower
than Seat Width6β Narrower
than Seat Width4β Narrower
than Seat Width
12β 9.5β 7.5β
13β 10.5β 8.5β
14β 11.5β 9.5β 9.5β
15β 12.5β 10.5β 10.5β
16β 13.5β 11.5β 9.5β 11.5β
17β 14.5β 12.5β 10.5β 12.5β
18β 15.5β 13.5β 11.5β 13.5β
19β 16.5β 14.5β 12.5β 14.5β
20β 17.5β 15.5β 13.5β 15.5β
F. Front Seat Height See Diagram 1
Measured from floor to top of seat tube at front of seat sling.
Phone (800) 981-1540 | Fax (715) 254-0996
[email protected] | www.kimobility.com
G. Footrest Width See Diagram 1
Measured from inside of front tube to inside of front tube on other side. Footrest width is listed below for each seat width and taper.
E. Footrest Taper See Diagram 1
Indicates bend of front frame creating footrest. Taper is measured from outside of seat frame to outside of front tube.
H. Seat to Footrest Length See Diagram 3
Measured from front edge of seat sling to top rear of footrest. Footrest length of at least 2.5β shorter than front seat height recommended.
I. Rear Seat Height See Diagram 3
Measured from floor to top of seat tube at front of back post.
J. Center of Gravity Preset See Diagram 3
Measured from front of back post to center of rear axle. 0β indicates axle will be directly under back post.
K. Rear Wheel Spacing See Diagram 1
Measured from outside of seat back to inside of rear tire. Adjustable from .75β to 1.75β.
DCN0384.4 Pricing and specifications subject to change without notice Page 8 of 8
Diagram 3
Diagram 1
Diagram 2
G E
G E
F
A K
Classic
Performance
C
H
B
D
I H
B
J
DCN0537.0 Pricing and specifications subject to change without notice Page 1 of 1
Width
14β 15β 16β 17β 18β 19β 20β 21β 22β
Dep
th
14β q15β q q q16β q q q q q q q17β q q q q q q q18β q q q q q q q q19β q q q q q q q20β q q q q q q q21β q q q q q22β q q q q q
Width
14β 15β 16β 17β 18β 19β 20β 21β 22βD
epth
14β q q q15β q q q q q16β q q q q q q q q17β q q q q q q q q18β q q q q q q q q q19β q q q q q q q q q20β q q q q q q q q q21β q q q q q q q q22β q q q q q q q q
Width
14β 15β 16β 17β 18β 19β 20β 21β 22β
Dep
th
14β q q q15β q q q q16β q q q q q q q q17β q q q q q q q q18β q q q q q q q q q19β q q q q q q q q q20β q q q q q q q q q21β q q q q q q q q22β q q q q q q q q
q Axiom G E2601 __________________________________________________________________________________ $120q Axiom S E2603 __________________________________________________________________________________ $210q Axiom P E2605 __________________________________________________________________________________ $355
q Axiom G E2602 __________________________________________________________________________________ $199q Axiom S E2604 __________________________________________________________________________________ $315q Axiom P E2606 __________________________________________________________________________________ $460
q Axiom SP - Visco E2607 _________________________________________________________________ $430q Axiom SP - Fluid E2607 __________________________________________________________________ $470
q Axiom SP - Visco E2608 _________________________________________________________________ $525q Axiom SP - Fluid E2608 __________________________________________________________________ $575
q Axiom G Extra Outer Cover ____________________________________________________________ $75q Axiom S Extra Outer Cover _____________________________________________________________ $85q Axiom P Extra Outer Cover _____________________________________________________________ $95q Axiom SP Extra Visco Outer Cover ____________________________________________ $105q Axiom SP Extra Fluid Outer Cover _____________________________________________ $105
q Axiom SP Extra Visco Inner Cover _____________________________________________ $105q Axiom SP Extra Fluid Inner Cover _______________________________________________ $105
Select size in chart below. Weight capacity: 350 lbs.
Solid Seat Insert ________________________________________________________________________________________ $60
Inner Cover Quantity: q 1 q 2If no selection is made, quantity 1 will be selected
Outer Cover Quantity: q 1 q 2If no selection is made, quantity 1 will be selected
Solid Seat Insert Quantity: q 1 q 2If no selection is made, quantity 1 will be selected
Axiom SP Cushion Quantity: q 1 q 2If no selection is made, quantity 1 will be selected
Axiom G, S or P Cushion Quantity: q 1 q 2If no selection is made, quantity 1 will be selected
Axiom G, S and P Cushions
Cushions Under 22β Wide
Outer Covers
22β Wide Cushions
Axiom SP Cushions
Cushions Under 22β Wide
22β Wide Cushions
Axiom Cushion Accessories
Solid Seat Insert
Inner Covers
Select size in chart at right. Weight capacity: 350 lbs.
Select size in chart at right. Weight capacity: 350 lbs.
Phone (800) 981-1540 | Fax (715) 254-0996
[email protected] | www.kimobility.com
DCN0538.1 Pricing and specifications subject to change without notice Page 1 of 5
Phone (800) 981-1540 | Fax (715) 254-0996
[email protected] | www.kimobility.com
Axiom Back Select back that is the same or up to 2β narrower than the width of the frame. Hardware is included with back. Low Back selections are not available with headrests, modifications, or posture supports. Weight capacity: 300 lbs.
Width
12β 14β 16β 18β 20β 22βRetail $555 $555 $555 $555 $555 $791
HCPC E2613 E2613 E2613 E2613 E2613 E2614
Hei
gh
t Lo
w
8β q AXPB1208 q AXPB1408 q AXPB1608 q AXPB1808 q AXPB2008
10β q AXPB1410 q AXPB1610 q AXPB1810 q AXPB2010 q AXPB2210
12β q AXPB1212 q AXPB1412 q AXPB1612 q AXPB1812 q AXPB2012
Mid
14β q AXPB1414 q AXPB1614 q AXPB1814 q AXPB2014 q AXPB2214
16β q AXPB1216 q AXPB1416 q AXPB1616 q AXPB1816 q AXPB2016
18β q AXPB1418 q AXPB1618 q AXPB1818 q AXPB2018 q AXPB2218
Axiom Posterior Back (PB)
Width
12β 14β 16β 18β 20β 22βRetail $636 $636 $636 $636 $636 $862
HCPC E2615 E2615 E2615 E2615 E2615 E2616
Hei
gh
t
Lo
w
8β q AXPL1208 q AXPL1408 q AXPL1608 q AXPL1808 q AXPL2008
10β q AXPL1410 q AXPL1610 q AXPL1810 q AXPL2010 q AXPL2210
12β q AXPL1212 q AXPL1412 q AXPL1612 q AXPL1812 q AXPL2012
Mid
14β q AXPL1414 q AXPL1614 q AXPL1814 q AXPL2014 q AXPL2214
16β q AXPL1216 q AXPL1416 q AXPL1616 q AXPL1816 q AXPL2016
18β q AXPL1418 q AXPL1618 q AXPL1818 q AXPL2018 q AXPL2218
Tall 20β q AXPL1220 q AXPL1420 q AXPL1620 q AXPL1820 q AXPL2020
22β q AXPL1422 q AXPL1622 q AXPL1822 q AXPL2022 q AXPL2222
Axiom Posterior Lateral Back (PL)
Axiom Posterior Back - Low Axiom Posterior Back - Mid
Axiom Posterior Back Measurement Reference
Back Height A B Shell Contour Depth
Hei
gh
t Lo
w8β 10β 6.5β
2.25β
10β 12β 8.5β
12β 14β 10.5β
Mid
14β 16β 8.5β
16β 18β 9.5β
18β 20β 10.5β
A
4.1
BA
4.1
B
Axiom Posterior Lateral Back Measurement Reference
Back Height A B Shell Contour Depth
Hei
gh
t
Lo
w
8β 10β 6.5β
3.65β
10β 12β 8.5β
12β 14β 10.5β
Mid
14β 16β 8.5β
16β 18β 9.5β
18β 20β 10.5β
Tall 20β 22β 11.5β
22β 24β 12.5βAxiom Posterior Lateral
Back - LowAxiom Posterior Lateral
Back - MidAxiom Posterior Lateral
Back - Tall
A
5.5
B
5.5
AB
A
5.5
B
DCN0538.1 Pricing and specifications subject to change without notice Page 2 of 5
Width
12β 14β 16β 18β 20β 22βRetail $735 $735 $735 $735 $735 $813
HCPC E2620 E2620 E2620 E2620 E2620 E2621
Hei
gh
t
Lo
w
8β q AXLB1208 q AXLB1408 q AXLB1608 q AXLB1808 q AXLB2008
10β q AXLB1410 q AXLB1610 q AXLB1810 q AXLB2010 q AXLB2210
12β q AXLB1212 q AXLB1412 q AXLB1612 q AXLB1812 q AXLB2012
Mid
14β q AXLB1414 q AXLB1614 q AXLB1814 q AXLB2014 q AXLB2214
16β q AXLB1216 q AXLB1416 q AXLB1616 q AXLB1816 q AXLB2016
18β q AXLB1418 q AXLB1618 q AXLB1818 q AXLB2018 q AXLB2218
Tall 20β q AXLB1220 q AXLB1420 q AXLB1620 q AXLB1820 q AXLB2020
22β q AXLB1422 q AXLB1622 q AXLB1822 q AXLB2022 q AXLB2222
Axiom Lateral Back (LB)
Axiom Back continued Select back that is the same or up to 2β narrower than the width of the frame. Hardware is included with back. Low Back selections are not available with headrests, modifications, or posture supports. Weight capacity: 300 lbs.
Axiom Lateral Back Measurement Reference
Back Height A B Shell Contour Depth
Hei
gh
t
Lo
w
8β 10β 6.5β
3.65β
10β 12β 8.5β
12β 14β 10.5β
Mid
14β 16β 8.5β
16β 18β 9.5β
18β 20β 10.5β
Tall 20β 22β 11.5β
22β 24β 12.5βAxiom Lateral
Back - LowAxiom Lateral
Back - MidAxiom Lateral
Back - Tall
A
5.5
B
5.5
AB
A
5.5
B
Axiom Deep Lateral Back (DL)
Width
12β 14β 16β 18β 20β 22βRetail $735 $735 $735 $735 $735 $813
HCPC E2620 E2620 E2620 E2620 E2620 E2621
Hei
gh
t
Mid
14β q AXDL1214 q AXDL1414 q AXDL1614 q AXDL1814 q AXDL2014 q AXDL2214
16β q AXDL1416 q AXDL1616 q AXDL1816 q AXDL2016
18β q AXDL1218 q AXDL1418 q AXDL1618 q AXDL1818 q AXDL2018 q AXDL2218
Tall 20β q AXDL1220 q AXDL1420 q AXDL1620 q AXDL1820 q AXDL2020
22β q AXDL1422 q AXDL1622 q AXDL1822 q AXDL2022 q AXDL2222
Axiom Deep Lateral Back Measurement Reference
Back Height A
B1 Shell Contour Depth12β 14β 16β 18β 20β 22β
Hei
gh
t
Mid
14β 16β 8.25β 8.25β 8.25β 8.25β 8.25β 8.25β
6β
16β 18β 9.25β 9.25β 9.25β 9.25β 9.25β 9.25β
18β 20β 10.25β 10.25β 10.25β 10.25β 10.25β 10.25β
Tall 20β 22β 9.5β 9.75β 10β 10.25β 10.25β 10.5β
22β 24β 10.75β 11β 11.25β 11.5β 11.5β 11.75β1 Measurement based on back width
Axiom Deep Lateral Back - Mid Axiom Deep Lateral Back - Tall
AB
7.75
AB
7.75
Phone (800) 981-1540 | Fax (715) 254-0996
[email protected] | www.kimobility.com
Description Item Code HCPC Retail (Each)
q Headrest Flip Down MountOnly available with HEDHMD401/HEDHMD417
HDR100 E1028 $170
q Universal Mounting PlateFor use with other manufacturer headrests
UMP K0108 $40
DCN0538.1 Pricing and specifications subject to change without notice Page 3 of 5
Axiom Back Accessories
Headrest and HardwareChoose headrest and hardware combination in chart below. Not available with Low Backs.
Phone (800) 981-1540 | Fax (715) 254-0996
[email protected] | www.kimobility.com
HEDHDW101/HEDHDW117 HEDHDW201/HEDHDW217 HEDHDW401/HEDHDW417
HEDPAD408
HEDPAD410
HEDPAD414
HEDPAD201
HEDPAD202
HEDPAD203
HEDPAD502
HEDPAD503
Hardware
Standard Straight Back Mount Hardware with Ball
Multi Axis Removable Hardware with Horizontal Bar
Headrest Hardware with Ball
HEDHDW101 / HEDHDW117 HEDHDW201 / HEDHDW217 HEDHDW401 / HEDHDW417
Description Item Code HCPC Kio Code Retail Kio Code Retail Kio Code Retail
Hea
dre
st P
ad
Comfort Plus Headrest 8β HEDPAD408 E0955E1028 q HDR001 $277 q HDR009 $313 q HDR017 $388
Comfort Plus Headrest 10β HEDPAD410 E0955E1028 q HDR002 $277 q HDR010 $313 q HDR018 $388
Comfort Plus Headrest 14β HEDPAD414 E0955E1028 q HDR003 $277 q HDR011 $313 q HDR019 $388
Small All Positioning Headrest Pad and Ring Only HEDPAD201 E0955
E1028 q HDR004 $277 q HDR012 $313 q HDR020 $388
Medium All Positioning Headrest Pad and Ring Only
HEDPAD202 E0955E1028 q HDR005 $277 q HDR013 $313 q HDR021 $388
Large All Positioning Headrest Pad and Ring Only HEDPAD203 E0955
E1028 q HDR006 $277 q HDR014 $313 q HDR022 $388
Tri-Comfort Plus Headrest 14β
HEDPAD502 E0955E1028 q HDR007 $288 q HDR015 $324 q HDR023 $399
Tri-Comfort Plus Headrest 19β
HEDPAD503 E0955E1028 q HDR008 $288 q HDR016 $324 q HDR024 $399
Headrest Hardware Options
DCN0538.1 Pricing and specifications subject to change without notice Page 4 of 5
Axiom Back Accessories continued
Available only with Axiom Lateral Back and Axiom Deep Lateral back
Description Item Code HCPC Retail
q Lumbar Pad 12β L12 K0108 $48
q Lumbar Pad 14β L14 K0108 $48
q Lumbar Pad 16β L16 K0108 $48
q Lumbar Pad 18β L18 K0108 $48
q Lumbar Pad 20β L20 K0108 $48
q Lumbar Pad 22β L22 K0108 $48
Lumbar Pads
Description Item Code HCPC Retail
q Privacy Flap 12β PF12 K0108 $45
q Privacy Flap 14β PF14 K0108 $45
q Privacy Flap 16β PF16 K0108 $45
q Privacy Flap 18β PF18 K0108 $45
q Privacy Flap 20β PF20 K0108 $45
q Privacy Flap 22β PF22 K0108 $45
Privacy Flap
Phone (800) 981-1540 | Fax (715) 254-0996
[email protected] | www.kimobility.com
Lateral Support
Laterals for Posterior BackPair Left Right Description Item Code HCPC Pair Each
q q q 3 x 4 Lateral Pads with Fixed Mounting Hardware for Axiom Posterior Back LF3x4P E0956 $305 $153
q q q 4 x 5 Lateral Pads with Fixed Mounting Hardware for Axiom Posterior Back LF4x5P E0956 $305 $153
q q q 3 x 4 Lateral Pads with Swing Away Mounting Hardware for Axiom Posterior Back LS3x4P E0956, E1028 $650 $325
q q q 4 x 5 Lateral Pads with Swing Away Mounting Hardware for Axiom Posterior Back LS4x5P E0956, E1028 $650 $325Laterals for Posterior Lateral BackPair Left Right Description Item Code HCPC Pair Each
q q q 3 x 4 Lateral Pads with Fixed Mounting Hardware for Axiom Posterior Lateral Back LF3x4L E0956 $305 $153
q q q 4 x 5 Lateral Pads with Fixed Mounting Hardware for Axiom Posterior Lateral Back LF4x5L E0956 $305 $153
q q q3 x 4 Lateral Pads with Swing Away Mounting Hardware for Axiom Posterior Lateral Back
LS3x4L E0956, E1028 $650 $325
q q q4 x 5 Lateral Pads with Swing Away Mounting Hardware for Axiom Posterior Lateral Back
LS4x5L E0956, E1028 $650 $325
DCN0538.1 Pricing and specifications subject to change without notice Page 5 of 5
Axiom Back Accessories continued
Selection of a modification from the Axiom Back Modifications section required in order to mount posture supports. Not available with Low Backs.
Description Item Code HCPC Retail
q Small Static Therafit 2-Piece Chest Strap with H & L Adj and 1β Safety Strap 60153T E0960 $144
q Medium Static Therafit 2-Piece Chest Strap with H & L Adj and 1β Safety Strap 60154T E0960 $144
q Large Static Therafit 2-Piece Chest Strap with H & L Adj and 1β Safety Strap 60155T E0960 $144
q Small Dynamic Therafit Chest Strap with Dual D-Ring Adjustment 60110T E0960 $113
q Medium Dynamic Therafit Chest Strap with Dual D-Ring Adjustment 60111T E0960 $113
q Large Dynamic Therafit Chest Strap with Dual D-Ring Adjustment 60112T E0960 $113
q Small Dynamic Therafit Comfortfit Full Vest 30589T E0960 $167
q Medum Dynamic Therafit Comfortfit Full Vest 30590T E0960 $167
q Large Dynamic Therafit Comfortfit Full Vest 30591T E0960 $167
q XLarge Dynamic Therafit Comfortfit Full Vest 30592T E0960 $167
q XXLarge Dynamic Therafit Comfortfit Full Vest 30593T E0960 $167
q Small Dynamic Therafit Comfortfit Trim Vest 30618T E0960 $169
q Medum Dynamic Therafit Comfortfit Trim Vest 30619T E0960 $169
q Large Dynamic Therafit Comfortfit Trim Vest 30620T E0960 $169
q XLarge Dynamic Therafit Comfortfit Trim Vest 30621T E0960 $169
q XXLarge Dynamic Therafit Comfortfit Trim Vest 30622T E0960 $169
Therafin Posture Support
Choose modification to add holes to the back shell in order to mount posture supports. Not available with Low Backs.
Description Item Code HCPC Retail
q Modification for 4 Point Harness AXM4PT K0108 N/C
q Modification for 2 Point Chest Strap AXM2PT K0108 N/C
q Modification for Shoulder GuidesIncludes shoulder guides
AXMSG K0108 $50
Axiom Back Modifications
Gloss Finish Item Code Retail
q Black AXMBLK N/C
q Blue Skies AXMSKY N/C
q Bubblegum Pink AXMPNK N/C
q Candy Blue AXMCBL N/C
q Candy Purple AXMPUR N/C
q Candy Red AXMRED N/C
q Copper AXMCOP N/C
q Granny Smith AXMGSM N/C
q Metallic Fuchsia AXMMTF N/C
q Metallic Orange AXMMOR N/C
q Silver AXMSIL N/C
q Teal AXMTEA N/C
q Yellow AXMYLW N/C
Painted Back Shell ModificationIf no selection is made, standard Shadow Black will be used with no additional lead time
Axiom Back Modifications Extended lead times will apply for all modifications
Phone (800) 981-1540 | Fax (715) 254-0996
[email protected] | www.kimobility.com
Matte Finish Item Code Retail
q Charcoal Gray AXMCGM N/C
q Emerald Green AXMEGM N/C
q Iridescent Burgundy AXMIBM N/C
q Iridescent Navy AXMINM N/C
q Military Green AXMAGM N/C
q Retro Red AXMRRM N/C
q Royal Blue AXMRBM N/C
q Smooth White AXMSWM N/C