move - motion composites · 1 wc01 ultralight move wheelchair aluminum. ... 33 bc02 8° bend...
TRANSCRIPT
160 Armand-Majeau Sud
Saint-Roch-de-l'Achigan, QC, Canada J0K 3H0
T.+1-866-650-6555 F. +1-888-966-6555
MOVEORDER FORM - CANADA
P.O. number:* Date: Ship to:*
Company Name:* Phone:* Name:
Ordered by:* Address:
Clinician/ATP/RTS: City: Prov:
Email: Postal Code:
Marked for: Phone:
* Required
MODEL
1 WC01 Ultralight MOVE wheelchair aluminum. (265 lb weight capacity) $1 395 □
2 WC09 Heavy duty kit (350 lb weight capacity) $775 □
SEAT WIDTH 3
3 SW Seat width: 14" □ 16" □ 18" 1 □ NC □
4 SW Seat width: 20" 1 □ 22" 2 □ $295 □
SEAT DEPTH
5 SD Seat depth: 16" □ 18" □ NC □
6 SD Seat depth: 20" □ $225 □1 - Available with HD option 2 - Only available with HD option 3. Width calculator
STD +1" +2" STD +1" +2" STD +1" +2" STD +1" +2" STD +1" +2"
P1 12 1/2 13 1/2 14 1/2
P2 13 14 15 13 1/2 14 1/2 15 1/2
P1
P2 13 14 15 13 1/2 14 1/2 15 1/2
P3 13 1/2 14 1/2 15 1/2 14 15 16 14 1/2 15 1/2 16 1/2
P4 14 15 16 14 1/2 15 1/2 16 1/2 15 16 17 15 1/2 16 1/2 17 1/2
P1 15 1/2 16 1/2 17 1/2 16 17 18
P2 15 1/2 16 1/2 17 1/2 16 17 18 16 1/2 17 1/2 18 1/2
P3 16 17 18 16 1/2 17 1/2 18 1/2 17 18 19 17 1/2 18 1/2 19 1/2
P4 16 17 18 16 1/2 17 1/2 18 1/2 17 18 19 17 1/2 18 1/2 19 1/2 18 19 20
P5 16 1/2 17 1/2 18 1/2 17 18 19 17 1/2 18 1/2 19 1/2 18 19 20 18 1/2 19 1/2 20 1/2
Height available +- 1/4" (see stem bolt and fork combination at the end of the order form)
WAMB
WAMA
MA080
English Manual (STD)
MA081
Manuel FrançaisTaxes not included
WM0001196
WAMF
5.1
Fork/Position
4"
5"
7"
Move FRONT Seat-to-floor Height - Please select your choice4" caster 5" caster 6" caster 7" caster 8" caster
Stem bolt length Stem bolt length Stem bolt length Stem bolt length Stem bolt length
Motion CompositesT.450 588-6555 1 866 650-6555 F.1 888 966-6555 MOVE Orderform CAN 5.1.xlsx March 23rd, 2020 1 of 5
CASTERS
7 CA01 Composite wheel w/ PU tire (1" width) 4" □ 5" □ 6" □ 7" □ 8" □ NC □
8 CA10 Pneumatic 6" x 1 ¼" $160 □
9 CA11 Pneumatic 8" x 1 ¼" $160 □
10 CA14 4" x 1 ½ " $98 □
11 CA15 5" x 1 ½ " $98 □
12 CA16 6" x 1 ½ " $98 □
13 CA17 4" x 1 ½" $175 □
14 CA18 5" x 1 ½" $185 □
15 CA19 6" x 1 ½" $195 □
Note: Tire size, center of gravity setting and seat slope may result in a variation of +/- ½” of selected seat to floor height"
SWING-AWAY FOOTREST
16 FR01 60° swing away footrest 13.5 - 17.5" □ 15.5 - 19.5" □ 17 - 21" □ $250 □
17 FR02 70° swing away footrest 13.5 - 17.5" □ 15.5 - 19.5" □ 17 - 21" □ $250 □
FOOTREST OPTIONS
18 FR09 High mount (footplate attached to the hanger with clamps) 5 - 13.5" □ $90 □
* +/- 1/2"
ELEVATING LEGREST (unit) The elevating legrest replace the footrest side selected
19 FR10 Elevating legrest with calf pad, 14” - 22” Length adjustable Left □ Right □ $390 □
FOOTPLATES
20 FP01 STD □
21 FP02 Newton adjustable angle - Composite $145 □
22 FP03 $165 □
23 FP08 Length adjustable heel loop $25 □
24 FP09 Calf strap $52 □
25 FP30 Bodypoint Aeromesh Padded calf strap $129 □
26 FR27 Residual limb support swing away - flat 6"x8" Left □ Right □ $475 □
27 FR28 Residual limb support swing away - flat 8"x10" Left □ Right □ $475 □
28 FR29 Residual limb support swing away - flat 10"x10" Left □ Right □ $475 □
29 FR30 Residual limb support swing away - flat 10"x14" Left □ Right □ $475 □
30 FR32 Residual limb support swing away - contour 6"x8" Left □ Right □ $475 □
31 FR33 Residual limb support swing away - contour 8"x10" Left □ Right □ $475 □
32 BC01 8° bend aluminum back cane 16" □ 18" □ 20" STD □ NC □
ADJUSTABLE ANGLE BACK
33 BC02 8° bend aluminum back cane 16" □ 20" STD □ $309 □
34 90° □ 95° STD □ 100° □ 105° □ 110° □
New
19 1/4" 20"
Select back cane angle:
Standard - Composite
18"
Set at:*
Back canes with integrated fixed height push handle FIXED ANGLE BACK
16 1/4"
WAMK
18 1/4"
Set at:*
17 1/4" 18"
Set at:
19"
SEFND0010
FOOTPLATE ACCESSORIES
Footrest
13"
15"
15 1/4"
14 1/4"
16"
18"
17 1/4"
16"
SEFND0010
19"
17"
Move REAR Seat-to-floor Height - Please circle your choice
14 1/4"
15 1/4"
17"
14"
14"
20" 22" 24"
12 1/4"
16"
17"
Set at:*
Newton adjustable angle - Aluminum
Newton UltraCaster Soft-Roll Aluminum
15"
16 1/4"
25"
15"
WAMJ
WAMJ
26"
13 1/4"
Newton UltraCaster Soft-Roll Composite
SEFND0005
SEFND0005
RESIDUAL LIMB SUPPORT CONTOUR CUSHION (Swing away, depth, width, height and angle ajustable) - (unit)
SEFND0005
RESIDUAL LIMB SUPPORT FLAT CUSHION (Swing away, depth, width, height and angle ajustable) - (unit)
New SEFND0005
SEFND0005New
New
New
New
SEFND0005
Motion CompositesT.450 588-6555 1 866 650-6555 F.1 888 966-6555 MOVE Orderform CAN 5.1.xlsx March 23rd, 2020 2 of 5
35 PH04 Stroller handle (not available with the HD option) $210 □
36 PH03 Folding stabilizer bar $258 □ 1 - Stroller handle and stabilizer bar can't be combined
BACK UPHOLSTERY
37 BH05 Slip-on Nylon back upholstery NC □
38 BH06 Adjustable tension Nylon back upholstery $245 □
39 BH99 Omit back upholstery STD □
RIGID BACK
40 NXT back series □
SEAT CUSHIONS
41 SC01 2" Cushion $175 □
42 SC02 3" Cushion $195 □
43 SC99 NC □
44 NXT FIT cushion series □
ONE ARM DRIVE 1 Only available with Newton One rear wheels with Aluminum, Plastic coated Handrims
45 HR22 One arm drive 2, 3 24" left □ right □ $1 395 □
46 HR98 Omit handrim on opposite side of the One Arm Drive (OAD) NC □
REAR WHEELS
47 RW01 Mag 4 20" □ 22" □ 24" □ NC □
48 RW02 Newton One - spoke wheel 5 20" □ 22" □ 24" □ NC □
49 RW03 Newton Gravity - ultralight wheel 20" □ 22" □ 24" □ 25" □ 26" □ $360 □
TIRES
50 TI01 Soft Urethane 1 1/4 " STD □
51 TI02 Soft Urethane knobby 1 3/8 " $130 □
52 TI04 Soft Urethane - Shox 1" $155 □
53 TI05 Pneumatic 1 3/8 " $130 □
54 TI08 Pneumatic with Airless insert 1 3/8" $215 □
55 TI06 Pneumatic HP - 1" $150 □
56 TI07 Pneumatic HP - Schwalbe Marathon Plus 1'' $230 □ 1- Offered with handrims on each side of the wheelchair 2- Only standard handrim position available 3- Not available with HD option
4 - Not compatible with HP tires ; Only available with aluminum or plastic coated handrim in standard position 5- Not compatible with Shox tires
HANDRIM
57 HR01 STD □
58 HR02 $160 □
59 HR03 $430 □
60 HR07 Newton Air Grip 1 Noir □ $150 □
Newton Air Grip 1 (08) Sunkissed Orange □ (09) Burgundy □ (10) Sapphire Blue □
(11) Monster Green □ (12) Charcoal □ (13) Fuchsia □ (14) Steel Blue □
(15) Ferrari Red □ (16) Acid Green □ (17) White □ (18) Sky Blue □
62 HR28 Surge 1, 2, 3 (1-1/2" Oval handrim w/ Gripton high friction strip) $470 □
63 HR05 Surge LT 1, 2, 3 (1-1/8" Oval handrim w/ Gripton high friction strip) $500 □
64 HR04 Natural Fit 1, 2, 3 $500 □
65 HR99 NC □ 1 - Not available with Mag wheels or OAD 2 - Not available in 20" 3- Only standard handrim position available
Assembly position for aluminum and Newton AirGrip handrims
66 HR29 Standard Handrim position Full tab STD □
67 HR30 Narrow Handrim position Short tab 2 positions $25 □
68 HR31 Super Narrow Handrim Short tab 2 positions STD □ Short tab 1 position □ $25 □
Thumb piece4 selection Natural Fit handrims
69 HR23 Standard grip $190 □
70 HR27 Super grip $220 □
71 HR099 Omit thumb piece NC □ 4- Compatible with Surge, Surge LT handrims
See pricelist p.6
WAMO
WAMO
Rear wheels
Handrims
Handrims option
WAMO $330
WAMW
WAMO
STROLLER HANDLE AND STABILIZER BAR 1
See pricelist p.6
□
WAMD/WAME
24", 25", 26"
Plastic coated 3
Aluminum anodized
Q-Grip High friction Neoprene coated 1, 2, 3
Available
20", 22" 24"
22", 24", 25", 26"
22", 24", 25", 26"
20", 22", 24", 25", 26"
22", 24"
20", 22", 24", 25", 26"
61
Omit seat cushion
HR08
Omit handrim
Motion CompositesT.450 588-6555 1 866 650-6555 F.1 888 966-6555 MOVE Orderform CAN 5.1.xlsx March 23rd, 2020 3 of 5
AXLES (0° camber)
72 AX01 Quick release axle STD □
73 AX02 Permanent axle NC □
74 AX03 Quad release axle $170 □
AXLE PLATE
75 AX04 Amputee adjustable axle plate 1 $250 □1 - May limit seat to floor height available
Choose position of rear wheel axle plate:
Measure distance from front of back post to center of axle receiver.
Default setting is at 3/4"
Most stable Most responsive
AMPUTEE 3/4" 2"
□ □ □
WHEEL LOCKS
76 WL08 Newton Wheel lock - push to lock STD □
77 WL02 Pull to lock NC □
78 WL04 Newton grade aid push to lock (suggested with pneumatic or high pressure tire) $175 □
79WL13
WL14 6" removable extension handle $67 □
80 WL06 $230 □
81 WL99 NC □
FLIP BACK ARMREST (Convertible to "T" armrest) 1, 2 Height Adjustment
82 AR01 10" Desk length arm pad 8 - 12" STD □ 10 - 14" □ $380 □
83 AR02 14" Full length arm pad 8 - 12" STD □ 10 - 14" □ $380 □
"T" ARMREST 1 Height Adjustment
84 AR03 8 - 12" STD □ 10 - 14" □ $360 □
85 AR04 8 - 12" STD □ 10 - 14" □ $360 □
GEL ARM PAD
86 AR12 14'' Full Length Arm Pad - Gel Ovation $150 □
87 AR99 NC □ 1 - May have a 1/2 " adjustment restriction on both limits of the range 2- Not available with attendant lock
POSITIONING BELTS
88 SB01 Velcro adjustable Standard 35" □ Long 60" □ $45 □
89 SB02 Auto buckle Standard 35" □ Long 60" □ $55 □
90 SB07 Hardware attachment for 2 point seatbelt (1 pair) NC □
91 SB03 $13 □
92 SB04 BodyPoint Hip Belt - 2 point not padded Medium 56" □ Long 61" □ $82 □
93 SB05 BodyPoint Hip Belt - 2 point padded Small 51" □ Medium 56" □ Long 61" □ $170 □
94 SB06 BodyPoint Hip Belt - 4 point padded Small 51" □ Medium 56" □ Long 61" □ $195 □
95 SB08 BodyPoint EVOFLEX® Positioning Belt Rehab latch and Band Clamps Medium 18"□ Long 24" □ $324 □
96 SB99 Omit positioning belt NC □
97 AC01 Profiled Headrest Small (3.5"X6") □ Medium (4.5"X7") □ Large (5.5"X8") □ $205 □
98 AC28 Headrest mounting hardware with stabiliser bar $338 □1 - Not available with a stroller handle or a folding stabiliser bar
SERND0030
SERND0020
Omit armrest
Locked □ Unlocked □ STD
Locked □ Unlocked □ STD
WAMU
14" Full length arm pad
Additional hardware for 2 extra attachment points (needed for the 4 point seat belt) (1 pair)
HEADREST 1
SEAND0030
Attendant Lock (additional set of wheel lock mounted to the back)
10" Desk length arm pad
Removable function
Omit wheel locks
WAMR
WAMT
CENTER OF GRAVITY
Armrests
WAMU
Motion CompositesT.450 588-6555 1 866 650-6555 F.1 888 966-6555 MOVE Orderform CAN 5.1.xlsx March 23rd, 2020 4 of 5
ACCESSORIES
99 AC03 Anti tippers $115 □
100 AC27 Tip assist 1 $60 □
101 AC04 Transit Tie Down (Unoccupied) NC □
102 AC05 WC-19 Transit Tie Down w/Q'straint belt 2 Short belt 20-41" □ Long belt 20-46" □ $345 □
103 AC06 Cane carrier Left □ Right □ $105 □
104 AC07 Left $375 □
105 AC08 Spoke guards 3 Available: 20", 22", 24", 26" $145 □
106 AC09 Footrest neoprene impact guard (pair) - Black $80 □
107 AC10 Seat pouch $95 □
108 AC26 BodyPoint Mobility Bag $135 □
109 AC23 Newton Backpack $120 □
110 AC12 Velcro Closing Strap $50 □
111 AC13 Tool kit $50 □
W/S □ W/M □ W/L □
M/S □ M/M □ M/L □ M/XL □ M/XXL □ M/XXXL □ M/XXXXL □
1 - Cannot be combined with Anti Tippers 2 - Not available with HD option
3 - Not available with Mag wheels
113 FC01 Black □ NC □
Sunkissed Orange □ Burgundy □ Sapphire Blue □ Monster Green □
Charcoal □ Fuchsia □ Steel Blue □ Ferrari Red □ Acid Green □
115 FC99 Custom Color Specify PPG Paintit color: $410 □
Notes :
WAMX
Fork and Stem bolt combinations
FRAME COLOR (with black aluminum crossbrace)
114 $270 □FC03
TOTAL
SEFND0035
Oxygen tank holder - E Type Not compatible with swing away armrest or amputee axle plate
WAMP
112 AC16 □$32 Motion Composites Polo shirt
Additional 10 days
lead-time
Motion CompositesT.450 588-6555 1 866 650-6555 F.1 888 966-6555 MOVE Orderform CAN 5.1.xlsx March 23rd, 2020 5 of 5
SEATING SERIES – FOLDING ON CHAIR – CANADIAN ORDER FORM Effective: March 2020
BioFit™ Fits Width Depth $ 3
NXCABF1616 15”-16” 16” 595
NXCABF1618 15”-16” 18” 595
NXCABF1620 15”-16” 20” 595
NXCABF1816 17”-18” 16” 595
NXCABF1818 17”-18” 18” 595
NXCABF1820 17”-18” 20” 595
BioFit™
BioFit™ CUSHION
Optima™ THORACIC BACK SUPPORT
Optima™ Fits Width Height $ 3
NOACB1613 16”-18” 13” 690
NOACB1616 16”-18” 16” 690
NOACB1619 16”-18” 19” 690
NOACB1813 18”-20” 13” 690
NOACB1816 18”-20” 16” 690
NOACB1819 18”-20” 19” 690
NOACB2016 20”-22” 16” 690
NOACB2019 20”-22” 19” 690
NOACB2213 22”-24” 13” 720
NOACB2216 22”--24” 16” 720
NOACB2219 22”-24” 19” 720
Optima™
Optima™ DEEP THORACIC BACK SUPPORT
Optima™ DEEP Fits Width Height $ 3
NOPCB1616 16”-18” 16” 790
NOPCB1619 16”-18” 19” 790
NOPCB1816 18”-20” 16” 790
NOPCB1819 18”-20” 19” 790
NOPCB2016 20”-22” 16” 790
NOPCB2019 20”-22” 19” 790
NOPCB2213 22”-24” 13” 820
NOPCB2216 22”-24” 16” 820
NOPCB2219 22”-24” 19” 820
Optima™ DEEP
Classic™ Fits Width Height $ 3
NACB1616 16”-18” 16” 690NACB1618 16”-18” 18” 690NACB1816 18”-20” 16” 690NACB1818 18”-20” 18” 690NACB1820 18”-20” 20” 690NACB2020 20”-22” 20” 660NACB2216 22”-24” 16” 720NACB2218 22”-24” 18” 720NACB2220 22”-24” 20” 720
Classic™
Classic™ PELVIC BACK SUPPORT Classic™ DEEP PELVIC BACK SUPPORT
Classic DEEP™ Fits Width Height $ 3
NPCB1616 16”-18” 16” 690NPCB1618 16”-18” 18” 690NPCB1818 18”-20” 18” 690NPCB1820 18”-20” 20” 690NPCB2020 20”-22” 20” 690NPCB2216 22”-24” 16” 720NPCB2218 22”-24” 18” 720NPCB2220 22”-24” 20” 720
Classic™ DEEP
ALL PRICES QUOTED IN CDN. PRICES ARE SUBJECT TO CHANGE WITHOUT NOTICE.For additional NXT models, sizes and hardware not shown, please refer to the complete NXT Seating Order Form at www.motioncomposites.com
Model #NIB-0784 $ 3 Model # NIB-0818 $ 3
10” x 5” Large Rectangular 195 14” x 5” Extra-Large
Rectangular 195
Model #NIB-0747 $ 3 Model # NIB-0823 $ 3
Multi-Axis Hardware 145 Head Support Receiver Bracket 55
MultiFit™ HEAD SUPPORT – MULTI-ADJUSTABLE PADS MultiFit™ HEAD SUPPORT – FIXTURES
TH
OR
AC
ICS
HA
PE
Xtend™ Fits Width Height $ 3
NHAACB1616/20 16”-18” 16”-20” 690
NHAACB1816/20 18”-20” 16”-20” 690
NHAACB2016/20 20”-22” 16”-20” 690
NHAACB2216/20 22”-24” 16”-20” 720
Xtend™
Xtend™ HEIGHT ADJUSTABLE THORACIC BACK SUPPORT Xtend™ DEEP HEIGHT ADJUSTABLE THORACIC BACK SUPPORT
Xtend™ Fits Width Height $ 3
NHAACB1616/20 16”-18” 16”-20” 690
NHAACB1816/20 18”-20” 16”-20” 690
NHAACB2016/20 20”-22” 16”-20” 690
NHAPCB2216/20 22”-24” 16”-20” 720
Xtend™ DEEP
PE
LV
IC S
HA
PE
BioFit™ Fits Width Depth $ 3
NXCABF2016 19” - 20” 16” 595
NXCABF2018 19”, - 20” 18” 595
NXCABF2020 19” - 20” 20” 625
NXCABF2216 21” - 22” 16” 625
NXCABF2218 21” - 22” 18” 625
NXCABF2220 21” - 22” 20” 625