q qqqqqqqqq q qqqqqqqqq - Care Medical Equipment...Rear Wheel Type q Assembled 24” Six-Spoke Mag with Treaded Tire and Composite Handrim _____ - $25 No substitutions available. Do

Company: ________________________________________________

Account Number: __________________ Date: _________________

q Quote q PO Number: ___________________________________

RTS: _____________________________________________________

Marked For: _______________________________________________

Ship To: __________________________________________________

Address: _________________________________________________

City: ________________________________ State: _____________

Zip: ________________ Phone: _____________________________

Email/Fax: ________________________________________________

Frame

Seat Width / Seat DepthSelect box corresponding to desired Seat Width and Depth

Seat Width

14” 15” 16” 17” 18” 19” 20” 21” 22”

PriceHCPCS

$45 $45 N/C $45 N/C $150$395E2201

$495E2201

$495E2201

Sea

t D

epth

14” N/C q q q q q q q q q15” $70 q q q q q q q q q16” N/C q q q q q q q q q17” $90 q q q q q q q q q18” N/C q q q q q q q q q19” $195 q q q q q q q q q20” $450

E2203 q q q q q q q q q

Heavy Duty Option

q 350 lb Weight Capacity __________________________________________________________________ $500Requires minimum 6” caster height

Cross Brace

q Standard Cross Braces _____________________________________________________________________ Stdq Seating System Cross Braces _______________________________________________________ N/C

Allows for easy attachment of seating system mounting hardware. Not available with Seat Sling.

Catalyst 4C K0004 ______________________________________________________________________ $1525250 lb weight capacity

Backrest

Back Post / Height Range / Back HeightSelect Back Height in row corresponding to desired Back Post and Height Range

BackPost

Price Height Range

Back Height

Standard N/C

Short q 8.5 q 9.5 q 10.5 q 11.5

Medium q 12.5 q 13.5 q 14.5 q 15.5

Tall q 16.5 q 17.5 q 18.5 q 19.5

Angle Adjustable w/ Push Handle

$185

Short q 14 q 15 q 16

Medium q 16 q 17 q 18

Tall q 18 q 19 q 20

Standard Back PostSelect option below only if a Standard Back Post option is selected on chart at left

q Straight with Push Handle ________________________________________________________________ Stdq Straight without Push Handle ________________________________________________________ N/Cq 8º Bend with Push Handle ______________________________________________________________ $25

Not available with Short Back Height Range

Phone (800) 981-1540 | Fax (715) [email protected] | www.kimobility.com

DCN0013.28 Pricing and specifications subject to change without notice Page 1 of 12

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 payer’s coverage policy.

Seat Pan

q Removable Aluminum Seat Pan E2231 _____________________________________ $245Pan depth 1/2” shorter than Seat Depth

Effective 04/08/2019

Select if chair quote has: q Additional Ki Products with Different Quote/Order Number Quote/Order Number: ____________________

Footrest

Hanger Bend

q 60º __________________________________________________________________________________________________________ N/CAvailable only with Extension Tube Hangers

q 70º __________________________________________________________________________________________________________ N/Cq 80º __________________________________________________________________________________________________________ N/C

Not available with 7” or 8” Casters

q 90º __________________________________________________________________________________________________________ N/CAvailable only with Front Mount Hangers. Not available with 7” or 8” Casters.

q Elevating Leg Rests (ELR) E0990 __________________________________________________ $295q Pro Elevating Leg Rests (PRO ELR) E0990 _______________________________ $350q Omit Hangers ___________________________________________________________________________________ - $20

Footplate

q Composite ____________________________________________________________________________________________ N/CNot available with Front Mount Hanger or PRO ELR

q Composite Angle Adjustable K0040 ___________________________________________ $185Not available with Front Mount Hanger, ELR or 14” Seat Width

q Aluminum Angle Adjustable K0040 _____________________________________________ $185q One Piece Flip Up Angle Adjustable K0040 ______________________________ $190

Not available with Front Mount Hanger, ELR or PRO ELR

Phone (800) 981-1540 | Fax (715) 254-0996

[email protected] | www.kimobility.com

Backrest continued

Back Upholstery Military PatchAttached only if ordered with Tension Adjustable Back Upholstery

US Military Service Patch _______________________________________________________________________ $90q Army q Navy q Marines q Air Force q Coast Guard

q US Purple Heart Patch _____________________________________________________________________ $90

Purple Heart with Military Service Patch Combo __________________________ $145q Army q Navy q Marines q Air Force q Coast Guard

Footrest / Extension / Seat to Footrest LengthSelect Seat to Footrest Length in row corresponding to desired Footrest and Extension. Footrest Length of at least 2.5” shorter than Front Seat Height recommended. Extension Tube Hanger measurements are based on 70º Hanger / Front Frame Bend.

Footrest Extension Seat to Footrest Length

Extension TubeHangers(60º, 70º, 80º)

Short q 11 q 11.5 q 12 q 12.5 q 13 q 13.5 q 14 q 14.5 q 15

Medium q 13 q 13.5 q 14 q 14.5 q 15 q 15.5 q 16 q 16.5 q 17

Long q 15.5 q 16 q 16.5 q 17 q 17.5 q 18 q 18.5 q 19 q 19.5

Front Mount Hangers 1

Standard Selections Requires 3” Extension for $35

Short(70º, 80º, 90º)

q 5 q 5.5 q 6 q 6.5 q 7 q 10 q 10.5 q 11

q 7.5 q 8 q 8.5 q 9 q 9.5 q 11.5 q 12 q 12.5

Medium(70º, 80º, 90º)

q 5 q 5.5 q 6 q 6.5 q 7 q 7.5 q 8 q 12 q 12.5 q 13

q 8.5 q 9 q 9.5 q 10 q 10.5 q 11 q 11.5 q 13.5 q 14 q 14.5

Long(70º, 80º)

q 5 q 5.5 q 6 q 6.5 q 7 q 7.5 q 8 q 8.5 q 9 q 14 q 14.5 q 15

q 9.5 q 10 q 10.5 q 11 q 11.5 q 12 q 12.5 q 13 q 13.5 q 15.5 q 16 q 16.5

Elevating Leg Rests (ELR)

Short q 12 q 13 q 14 q 15 q 16

Long q 13 q 14 q 15 q 16 q 17 q 18

Extended Length ELR

Short q 18 q 19 q 20 q 21 q 22

Long q 18 q 19 q 20 q 21 q 22 q 23 q 24

PRO ELR Low Pivot Setting

Short q 12 - 17.5

Long q 15 - 21

PRO ELR High Pivot Setting

Short q 10.5 - 15.5

Long q 13 - 191 See Minimum Front Seat Height chart below.

Minimum Front Seat Height with Front Mount Hangers

Hanger Length Short Medium Long

Hanger Bend 70º 80/90º 70º 80/90º 70º 80º

Minimum Front Seat Height with Standard Selection

13.5” 13.5” 14” 15” 16” 17”

Minimum Front Seat Height with 3” Extension

14.5” 16” 16.5” 18” 18.5” 20”

3” ExtensionAvailable only with Front Mount Hangers. Provided as parts.

q 3” Extension for Front Mount Hanger __________________________________________ $35

q Standard ________________________________________________________________________________________________ StdNot available with Short or Medium Back Height Ranges on 20” - 22” Seat Widths

Tension Adjustable E2611

q Standard Cover _____________________________ $245 q Air Mesh Breathable Cover New! ______________ $320

q Omit Back Upholstery ___________________________________________________________________ - $10


Front Seat Height and Casters

Caster Type

q 1” Poly ___________________________________________________________________________________________________ N/Cq 1” Poly Aluminum _____________________________________________________________________________ $160

Available only with 4” and 5” Caster Sizes

q 1” Pneumatic _______________________________________________________________________________________ $85Available only with 6” and 8” Caster Sizes

q 1.5” Poly _______________________________________________________________________________________________ $50Not available with 7” and 8” Caster Sizes

q 1.5” Soft Roll Aluminum _________________________________________________________________ $175Not available with 7” and 8” Caster Sizes

q 2” Poly ___________________________________________________________________________________________________ $70Available only with 6” Caster Size

q 2” Pneumatic w/ Foam Insert ______________________________________________________ $225Available only with 8” Caster Size

Caster Size / Front Frame Type / Front Seat Height

Fork Options

Fork Stem

q Standard Fork Stem ___________________________________________________________________________ Stdq 3/4” Longer Fork Stem ____________________________________________________________________ $35q 1 1/2” Longer Fork Stem _________________________________________________________________ $35

q Frog Legs Ultra-Sport Fork - Black ____________________________________________ $425Available only with 4”, 5” or 6” Caster Sizes. Not available with Caster Pin Locks, Heavy Duty Option, 2” Poly caster or 2” Pneumatic w/ Foam Insert caster.

End User Weight Required: ____________ lbs

q Caster Pin Locks K0073 _________________________________________________________________ $195Not available with 1 1/2” Longer Fork Stem or Frog Legs Fork

Phone (800) 981-1540 | Fax (715) 254-0996



Maximum Seat Dump Reference(Front Seat Height minus Rear Seat Height)

Seat Depth 14” 15” 16” 17” 18” 19” 20”

Maximum Dump 1.5” 2” 2” 2” 2.5” 2.5” 2.5”

Footrest continued

Heel LoopNot available with One Piece Flip Up Angle Adjustable Footplate

q Heel Loops E0951 ______________________________________________________________________________ $30q Adjustable Heel Loops E0951 ________________________________________________________ $50q Omit Heel Loops ________________________________________________________________________________ N/C

Residual Limb SupportResidual Limb Support E1020

q Left ____________________________ $395 q Right _____________________________ $395

q Omit Left Hanger ___- $10 q Omit Right Hanger ____ - $10

Cover q Smooth q Air Mesh q Smooth q Air Mesh

Pad Size q 5 x 8 q 9 x 14 q 5 x 8 q 9 x 14

q 7 x 10 q 11 x 10 q 7 x 10 q 11 x 10

q 9 x 10 q 11 x 14 q 9 x 10 q 11 x 14

Select Front Seat Height in row corresponding to desired caster size.Note: Selections in first three Front Seat Height columns use Super Low Front Frame.

Caster Size

Front Seat HeightUses Super Low Front Frame

4” q 13.51 q 14 q 14.5 q 152 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

5” 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 q 20.5

6” 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 q 20.5 q 21

7” q 17 q 17.5 q 18 q 18.5 q 19 q 19.5 q 20 q 20.5 q 21

8” q 17.5 q 18 q 18.5 q 19 q 19.5 q 20 q 20.5 q 211 Front Seat Height not available with 4 x 1” Poly Caster2 Super Low Front Frame required when using 4 x 1” Poly Caster

Calf Strap

q Velcro Adjustable K0038 ___________________________________________________________________ $35q Padded Velcro Adjustable K0038 __________________________________________________ $68q Bodypoint Padded AeroMesh K0038 _________________________________________ $102

Hanger ReleaseIf no selection is made Classic Hanger Release will be used

q Classic ____________________________________________________________________________________________________ Stdq 4-Way - In line _____________________________________________________________________________________ N/C

See reference A to the right. Not available with ELR or PRO ELR.

q 4-Way - Out _________________________________________________________________________________________ N/CSee reference B to the right. Not available with ELR or PRO ELR.

A B

Rear Wheel Type

q Assembled 24” Six-Spoke Mag with Treaded Tireand Composite Handrim ______________________________________________________________ - $25

No substitutions available. Do not select Rear Tire Type or Handrim. Measures as Full Profile tire. Not available with Heavy Duty Option.

q 24” Spoke ____________________________________________________________________________________________ N/Cq Spoke (20”, 22”, 25” or 26”) _________________________________________________________ $100q MAXX Performance Spoke New! _____________________________________________ $150

Available only in 22” or 24” wheel sizes

q Mag ________________________________________________________________________________________________________ N/CNot available in 25” or 26” wheel sizes

q Superlight Spoke _____________________________________________________________________________ $295Available only in 24” and 25” wheel sizes. 25” wheel size available only with Superlight and Plastic Coated Handrims. Not available with Heavy Duty Option.

Spinergy Spox _________________________________________________________________________________________ $820Not available in 20” wheel size

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

Rear Tire Type

q Street Pneumatic 1 3/8” E2211, E2212 ___________________________________________ StdNot available on 25” wheel size

q Full Poly 1 3/8” E2218 _______________________________________________________________________ N/CNot available on Superlight wheel or 25” or 26” wheel sizes

q Pneumatic with Airless Insert 1 3/8” E2211, E2213 ____________________ $95Not available on Superlight wheel or 25” wheel size

q Schwalbe HS-127 1 3/8” E2211, E2212 ______________________________________ $125Available only on 24” wheel size. Not available on Mag wheel.

q Euro Trek Knobby 1 3/8” E2211, E2212 __________________________________________ $95Available only on 24” wheel size

Handrim

Handrim Option

q 3M Micro Grip _____________________________________________________________________________________ $65Not available on Plastic Coated or Projection Handrims

q Low Poly 1” E2218 _____________________________________________________________________________ N/CNot available on Superlight wheel, 25” or 26” wheel sizes or Heavy Duty Option

q Sentinel Solid Tire 1” E2218 ____________________________________________________________ $95Not available on Superlight wheel or 20” and 22” Mag wheels

q High Pressure 1” E2211, E2212 ________________________________________________________ $95Not available on Mag wheel

Full Profile

Rear Seat Height and Wheels

Wheel Size / Tire Profile / Rear Seat Height

Low Profile

Phone (800) 981-1540 | Fax (715) 254-0996


q Aluminum Anodized ___________________________________________________________________________ Stdq Superlight Aluminum Anodized _____________________________________________________ $50

Available only on 24” and 25” wheel sizes. Available only on MAXX Performance, Superlight or Spinergy wheels. Not available with Heavy Duty Option.

q Plastic Coated _____________________________________________________________________________________ $95q Projection (8 Vertical Projections) ________________________________________________ $295

Available only with full profile tires in combination with MAXX Performance, 22”-26” Spoke, or 24” Mag wheel

q Omit Handrim ______________________________________________________________________________________ N/C

Standard Handrims Not available on 20” wheel size or 22” Mag wheel. Not recommended with Mag wheel.

q Natural Fit LT Regular Grip ____________________________________________________________ $445q Natural Fit Standard Regular Grip _______________________________________________ $445q Natural Fit LT Super Grip _______________________________________________________________ $495q Natural Fit Standard Super Grip __________________________________________________ $495q Natural Fit LT Omit Grip _________________________________________________________________ $345q Natural Fit Standard Omit Grip ____________________________________________________ $345

Natural Fit Handrims

Select Rear Seat Height in row corresponding to desired Wheel Size and Tire Profile. 14” Seat Depth not available with 24”, 25” or 26” wheel sizes.

WheelSize

TireProfile

Rear Seat Height

20”Low q 12.51 q 13.5 q 14.5 q 15.5 q 16.5

Full q 131 q 14 q 15 q 16 q 17

22”Low q 13.51 q 14.5 q 15.5 q 16.5 q 17.5

Full q 141 q 15 q 16 q 17 q 18

24”Low q 14.51 q 15.5 q 16.5 q 17.5 q 18.5

Full q 151 q 16 q 17 q 18 q 19

25” Low q 151 q 16 q 17 q 18 q 19

26”Low q 15.51 q 16.5 q 17.5 q 18.5 q 19.5

Full q 161 q 17 q 18 q 19 q 201 Not available with Flip Back Armrests


Wheel Locks

Wheel Lock Wheel Lock Options

q Push to Lock ________________________________________________________________________________________ Stdq Push to Lock Flush Mount ______________________________________________________________ N/Cq Pull to Lock __________________________________________________________________________________________ N/Cq Omit Wheel Locks _____________________________________________________________________________ N/C

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

Armrest Please select Arm Pad option

Removable Side Guard

q Height Adjustable T-Arm (8.5” - 13.5”) E0973 ________________________________ $265q Height Adjustable T-Arm Low (7.5” - 11.5”) E0973 ______________________ $265q Height Adjustable Flip Back T-Arm (9.5”-13.5”) E0973 _______________ $275q Flip Back (10.5”) ____________________________________________________________________________________ N/C

Not available with Seat Depths less than 16” or Angle Adjustable Back Posts

q Composite Side Guards K0108 ____________________________________________________ $140Not available with T-Arm or Flip Back Armrests

Accessories

Anti-Tip

q Rear Anti-Tips E0971 _______________________________________________________________________ $140

Positioning Belt

q 1 1/2” Auto Buckle E0978 ________________________________________________________________ $70q 1 1/2” Padded Auto Buckle E0978 _____________________________________________ $155q 2” Airline Buckle E0978 ___________________________________________________________________ $110

Bodypoint Evoflex - Pelvic Stabilizer E0978 ____________________________________ $183Size: q Small (16-24”) q Medium (19-29”) q Large (25-37”)

Bodypoint Belt Mounting Kit _______________________________________________________________ $105Style: q Bracket q Band Clamp 1”

Other Accessories

q Tool Kit ___________________________________________________________________________________________________ $45q Removable Underseat Pouch ________________________________________________________ $50q Ki Mobility Backpack ________________________________________________________________________ $65q Black Neoprene Impact Guards ____________________________________________________ $85q Clear Spoke Guards K0065 ___________________________________________________________ $115

Not available with Mag wheel

q Black Spoke Guards K0065 __________________________________________________________ $115Not available with 20” wheel size or Mag wheel

q Cane and Crutch Holder _______________________________________________________________ $195q IV Pole _________________________________________________________________________________________________ $265

Available only with Standard Straight Back Posts

Frame Color

Matte FinishGloss Finish

q Army Green __________________________________________________________________________________________ N/Cq Charcoal Gray _____________________________________________________________________________________ N/Cq Emerald Green ____________________________________________________________________________________ N/Cq Iridescent Burgundy __________________________________________________________________________ N/Cq Iridescent Navy ___________________________________________________________________________________ N/Cq Retro Red _____________________________________________________________________________________________ N/Cq Royal Blue ____________________________________________________________________________________________ N/Cq Shadow Black _____________________________________________________________________________________ N/Cq Smooth White _____________________________________________________________________________________ N/C

q Black ______________________________________________________________________________________________________ N/Cq Blue Skies ____________________________________________________________________________________________ N/Cq Bubblegum Pink _________________________________________________________________________________ N/Cq Candy Blue __________________________________________________________________________________________ N/Cq Candy Purple ______________________________________________________________________________________ N/Cq Candy Red ___________________________________________________________________________________________ N/Cq Copper __________________________________________________________________________________________________ N/Cq Granny Smith ______________________________________________________________________________________ N/Cq Metallic Fuchsia New! ____________________________________________________________________ N/Cq Metallic Orange __________________________________________________________________________________ N/Cq Yellow ____________________________________________________________________________________________________ N/C Hydrographics

Visit www.kimobility.com for current Hydrographics options. Note selection below

q $695

q Swing Away (10.5” - 12.5”) E0973 _____________________________________________________ $195Not available with Angle Adjustable Back Posts or Arm Pads

q Omit Armrests _____________________________________________________________________________________ N/C

Arm Pad

Armrests

Armrest continued

Phone (800) 981-1540 | Fax (715) 254-0996



O2 HolderO2 Holder E2208 ______________________________________________________________________________________ $295 q Right Side q Left Side

Not available with Swing Away Armrests

Standard Arm Pad __________ N/C q Desk q Full

Waterfall Arm Pad ____________ $25 q Desk q FullAvailable only with Height Adjustable T-Arm and Height Adjustable T-Arm Low

Axle

q Quick Release ______________________________________________________________________________________ Stdq Quad Quick Release _______________________________________________________________________ $195

Not available with Mag or Spinergy wheels

Axles

Axle Bracket

q Offset Axle Bracket _____________________________________________________________________________ Stdq Reverse Mount Offset Axle Bracket _____________________________________________ N/C

Not available with Swing Away Armrests

Phone (800) 981-1540 | Fax (715) 254-0996



Catalyst Front Seat Height Matrix

4” Caster 5” Caster 6” Caster 7” Caster 8” Caster

FSHSuper Low

Stem Fork FSHSuper Low




Stem Fork

151 13.51

Std

4”

16 14.5 Std

4”

17 15.5 Std

5”

18 17Std

6”

19 18 Std

6”15.5 14 16.5 15.5 3/4 18 16.5 3/4 18.5 17.5 20 18.5 3/4

162 14.52

3/417.5 16 1 1/2 18.5 17 1 1/2 19 17.5

3/420.5 n/a 1 1/2

16.5 15 16 15Std

5”

17 16

Std

6”

19.5 18 19 17.5

Std

7”

16.52 152

1 1/216.5 15.5 17.5 16.5 19.5 18.5

1 1/219.5 18

17 15.5 17 15.53/4

18 17 20 19 20 18.5

15.5 14.5Std

5”

17.5 16 18 16.5

3/4

18.5 17.5

Std

7”

20.5 19

16 15 17.5 16.51 1/2

18.5 17 19 18 19.5 18.5

3/416.5 15

3/418 17 19 17.5 19.5 18.5 20 19

17 15.5 16.5 15.5

Std

6”

18.5 17.5

1 1/2

20 19 20.5 n/a

17 161 1/2

17 16 19 18 19 18

3/4

21 n/a

17.5 16.5 17.5 16.5 19.5 18.5 19.5 18.5 20.5 191 1/2

17 15.5Std

6”

17.5 16

3/4

18 16.5

Std

7”

20 19 21 n/a

17.5 16 18 16.5 18.5 17 20.5 n/a 8” x 2” caster not available with 6” fork17.5 16.5

3/418.5 17 19 17.5 20 18.5

1 1/218 17 18 17

1 1/2

19.5 18.5 20.5 19

18.5 171 1/2

18.5 17.5 18.5 17.5

3/4

21 n/a

19 17.5 19 18 19 18

18 17Std

7”

18 16.5

Std

7”

19.5 18.5

18.5 17.5 18.5 17 20 19

19 17.53/4

19 17.5 19.5 18

1 1/219.5 18 18.5 17.5

3/4

20 18.5

19.5 18.51 1/2

19 18 20.5 19

20 19 19.5 18.5 21 n/a

19.5 18

1 1/2

6” x 2” caster not available with 5” fork

20 18.5

20.5 19

1 Front Seat Height not available with 4 x 1” Poly Caster 2 Not available with 4 x 1” Poly, 4 x 1.5” Poly or 4 x 1.5” Soft Roll Aluminum

Seat heights with “FSH” heading available with Standard Front Frame. Seat heights with “Super Low” heading available with Super Low Front Frame. Actual seat height may vary depending upon configuration.

Phone (800) 981-1540 | Fax (715) 254-0996



Axiom G, S and P Cushions

Cushions Under 22” WideWidth

14” 15” 16” 17” 18” 19” 20” 21” 22”

Dep

th

14” q15” q q q16” q q q q q q q17” q q q q q q18” q q q q q q q19” q q q20” q q q q q

q Axiom G E2601 __________________________________________________________________________________ $120q Axiom S E2603 __________________________________________________________________________________ $199q Axiom P E2605 __________________________________________________________________________________ $340

q Axiom G E2602 __________________________________________________________________________________ $199q Axiom S E2604 __________________________________________________________________________________ $299q Axiom P E2606 __________________________________________________________________________________ $440

q Axiom SP - Visco E2607 _________________________________________________________________ $410q Axiom SP - Fluid E2607 __________________________________________________________________ $449

q Axiom SP - Visco E2608 _________________________________________________________________ $499q Axiom SP - Fluid E2608 __________________________________________________________________ $549

Width

14” 15” 16” 17” 18” 19” 20” 21” 22”

Dep

th

14” q q q15” q q q q q16” q q q q q q q q17” q q q q q q q q18” q q q q q q q q q19” q q q q q q q q20” q q q q q q q q

Outer Covers

q Axiom G Extra Outer Cover ____________________________________________________________ $70q Axiom S Extra Outer Cover _____________________________________________________________ $80q Axiom P Extra Outer Cover _____________________________________________________________ $90q Axiom SP Extra Visco Outer Cover ____________________________________________ $100q Axiom SP Extra Fluid Outer Cover _____________________________________________ $100

q Axiom SP Extra Visco Inner Cover _____________________________________________ $100q Axiom SP Extra Fluid Inner Cover _______________________________________________ $100

22” Wide Cushions

Axiom SP Cushions

Cushions Under 22” Wide

22” Wide Cushions

Axiom Cushion Accessories

Select size in chart below. Weight capacity: 350 lbs.

Solid Seat Insert ________________________________________________________________________________________ $55

Solid Seat Insert

Inner Covers

Width

14” 15” 16” 17” 18” 19” 20” 21” 22”

Dep

th

14” q15” q q q16” q q q q q q q17” q q q q q q18” q q q q q q q19” q q q20” q q q q qInner Cover Quantity: q 1 q 2

If 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

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



New!Axiom Back Hardware is included with back. Low Back selections are not available with headrests. Weight capacity: 300 lbs.

Width

12” 14” 16” 18” 20” 22”Retail $555 $555 $555 $555 $555 $791

HCPC E2613 E2613 E2613 E2613 E2613 E2614

Hei

gh

t Lo

w

8” q AXPB1208 q AXPB1408 q AXPB1608 q AXPB1808 q AXPB2008



Mid




Axiom Posterior Back (PB)

Width

12” 14” 16” 18” 20” 22”Retail $636 $636 $636 $636 $636 $862

HCPC E2615 E2615 E2615 E2615 E2615 E2616

Hei

gh

t

Lo

w

8” q AXPL1208 q AXPL1408 q AXPL1608 q AXPL1808 q AXPL2008



Mid




Tall 20” q AXPL1220 q AXPL1420 q AXPL1620 q AXPL1820 q AXPL2020


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

w

8” 10” 6.5”

2.25”

10” 12” 8.5”

12” 14” 10.5”

Mid

14” 16” 8.5”

16” 18” 9.5”

18” 20” 10.5”

A

4.1

BA

4.1

B

Axiom Posterior Lateral Back Measurement Reference


Hei

gh

t

Lo

w

8” 10” 6.5”

3.65”

10” 12” 8.5”

12” 14” 10.5”

Mid

14” 16” 8.5”

16” 18” 9.5”

18” 20” 10.5”

Tall 20” 22” 11.5”

22” 24” 12.5”Axiom Posterior Lateral

Back - LowAxiom Posterior Lateral

Back - MidAxiom Posterior Lateral

Back - Tall

A

5.5

B

5.5

AB

A

5.5

B

Phone (800) 981-1540 | Fax (715) 254-0996



Width

12” 14” 16” 18” 20” 22”Retail $735 $735 $735 $735 $735 $813

HCPC E2620 E2620 E2620 E2620 E2620 E2621

Hei

gh

t

Lo

w

8” q AXLB1208 q AXLB1408 q AXLB1608 q AXLB1808 q AXLB2008



Mid




Tall 20” q AXLB1220 q AXLB1420 q AXLB1620 q AXLB1820 q AXLB2020


Axiom Lateral Back (LB)

Axiom Back continued Hardware is included with back. Low Back selections are not available with headrests. Weight capacity: 300 lbs.

Axiom Lateral Back Measurement Reference


Hei

gh

t

Lo

w

8” 10” 6.5”

3.65”

10” 12” 8.5”

12” 14” 10.5”

Mid

14” 16” 8.5”

16” 18” 9.5”

18” 20” 10.5”

Tall 20” 22” 11.5”

22” 24” 12.5”Axiom 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

12” 14” 16” 18” 20” 22”Retail $735 $735 $735 $735 $735 $813

HCPC E2620 E2620 E2620 E2620 E2620 E2621

Hei

gh

t

Mid

14” q AXDL1214 q AXDL1414 q AXDL1614 q AXDL1814 q AXDL2014 q AXDL2214

16” q AXDL1416 q AXDL1616 q AXDL1816 q AXDL2016

18” q AXDL1218 q AXDL1418 q AXDL1618 q AXDL1818 q AXDL2018 q AXDL2218

Tall 20” q AXDL1220 q AXDL1420 q AXDL1620 q AXDL1820 q AXDL2020

22” q AXDL1422 q AXDL1622 q AXDL1822 q AXDL2022 q AXDL2222

Axiom Deep Lateral Back Measurement Reference

Back Height A

B1 Shell Contour Depth12” 14” 16” 18” 20” 22”

Hei

gh

t

Mid

14” 16” 8.25” 8.25” 8.25” 8.25” 8.25” 8.25”

6”

16” 18” 9.25” 9.25” 9.25” 9.25” 9.25” 9.25”

18” 20” 10.25” 10.25” 10.25” 10.25” 10.25” 10.25”

Tall 20” 22” 9.5” 9.75” 10” 10.25” 10.25” 10.5”

22” 24” 10.75” 11” 11.25” 11.5” 11.5” 11.75”1 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



Axiom Back Accessories

Headrest and Hardware

HMO400 HMO475-1 TWB480-1

CP450

CP250

CP150

AP250

AP350

AP450

TCP205

TCP105

Choose headrest and hardware combination in chart below. Available only on Mid or Tall

Hardware

Standard Straight Back Mount Hardware with 1” Ball

Multi Axis Removable Hardware with 1” Horizontal Bar

Headrest Hardware with 1” Ball

HMO400 HMO475-1 TWB480-1Description Item Code HCPC Kio Code Retail Kio Code Retail Kio Code Retail

Hea

dre

st P

ad

Comfort Plus Headrest 8” CP450 E0955 q HDR001 $277 q HDR009 $313 q HDR017 $388



Small All Positioning Headrest Pad and Ring Only

AP250 E0955 q HDR004 $277 q HDR012 $313 q HDR020 $388

Medium All Positioning Headrest Pad and Ring Only


Large All Positioning Headrest Pad and Ring Only


Tri-Comfort Plus Headrest 14” TCP205 E0955 q HDR007 $288 q HDR015 $324 q HDR023 $399

Tri-Comfort Plus Headrest 19” TCP105 E0955 q HDR008 $288 q HDR016 $324 q HDR024 $399

For use with other manufacturer headrests

Description Item Code HCPC Retail

q Universal Mounting Plate UMP K0108 $40

Universal Mounting Hardware

Phone (800) 981-1540 | Fax (715) 254-0996



Axiom Back Accessories continued

Available only with Axiom Lateral Back and Axiom Deep Lateral back


q Lumbar Pad 12” L12 K0108 $48






Lumbar Pads


q Privacy Flap 12” PF12 K0108 $45






Privacy Flap

Lateral SupportSold in pairs


Laterals for Posterior Back

q 3 x 4 Lateral Pads with Fixed Mounting Hardware for Axiom Posterior Back LF3x4P E0956 $305

q 4 x 5 Lateral Pads with Fixed Mounting Hardware for Axiom Posterior Back LF4x5P E0956 $305

q3 x 4 Lateral Pads with Swing Away Mounting Hardware for Axiom Posterior Back

LS3x4P E0956, E1028 $650

q4 x 5 Lateral Pads with Swing Away Mounting Hardware for Axiom Posterior Back

LS4x5P E0956, E1028 $650

Laterals for Posterior Lateral Back and Lateral Back

q3 x 4 Lateral Pads with Fixed Mounting Hardware for Axiom Posterior Lateral and Axiom Lateral Backs

LF3x4L E0956 $305

q4 x 5 Lateral Pads with Fixed Mounting Hardware for Axiom Posterior Lateral and Axiom Lateral Backs

LF4x5L E0956 $305

q3 x 4 Lateral Pads with Swing Away Mounting Hardware for Axiom Posterior Lateral and Axiom Lateral Backs

LS3x4L E0956, E1028 $650

q4 x 5 Lateral Pads with Swing Away Mounting Hardware for Axiom Posterior Lateral and Axiom Lateral Backs

LS4x5L E0956, E1028 $650

Phone (800) 981-1540 | Fax (715) 254-0996



Axiom Back Accessories continued


q Small Static Therafit 2-Piece Chest Strap with H & L Adj and 1” Safety Strap 60153T E0960 $144

q Medium Static Therafit 2-Piece Chest Strap with H & L Adj and 1” Safety Strap 60154T E0960 $144

q Large Static Therafit 2-Piece Chest Strap with H & L Adj and 1” 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


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 Yellow AXMYLW N/C

Painted Back Shell Modification

Matte Finish Item Code Retail

q Army Green AXMAGM N/C

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 Retro Red AXMRRM N/C

q Royal Blue AXMRBM N/C

q Smooth White AXMSWM N/C

If 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

q qqqqqqqqq q qqqqqqqqq - Care Medical Equipment...Rear Wheel Type q Assembled 24” Six-Spoke Mag with Treaded Tire and Composite Handrim _____ - $25 No substitutions available. Do

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