Page 1 of 17 INFINFB3572/RevF/01MAY2018 Q6 Edge ® HD Order Form with TRU-Balance ® 3 Positioning - Group 3 Quantum ® Rehab 401 York Ave., Duryea, PA 18642 Phone: 866-800-2002 | Fax: 866-707-3422 | Email: [email protected]Account Number: ___________ Date: ________________ Provider Name: __________________________________ Contact: ________________________________________ Phone: ___________________ Fax: _________________ Email:__________________________________________ PO Number:_____________________________________ Marked for: _____________________________________ Ship to Address: _________________________________ City: _____________________ State: ______ Zip: ______ Weight:________ Height:________ PATIENT INFORMATION ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ A. Shoulder Width:_______ B. Chest Width: _________ C. Hip Width: ___________ D. Max Sitting Height: ____ E. Shoulder Height: ______ F. Axilla Height: _________ G. Thigh Depth: _________ H. Lower Leg Length: ____ I. Elbow Height: ________ INTRODUCTION This form is interactive when viewed with Adobe Acrobat Reader and may not function correctly if opened with applica- tions other than Acrobat. Complete the form by placing checks in the desired boxes and provide information in the interactive fields. Buttons shown at the bottom of the form may be utilized to print or submit the order form through a desktop email application. To email via a web-based application, please ‘Save As’ and attach the PDF to your email. This order form contains a large variety of options to fulfill various patient needs. Descriptions and section notes, such as optional or required, are included to help you complete your order. Please contact Quantum Sales at 866-800-2002 if assistance is needed. Send the completed order form by fax (866-707-3422) or email ([email protected]). Incomplete forms may delay the quote or order. Customer service will contact you if the order is incomplete or if there are compatibility issues. If special order requests are needed, be sure that the Patient Information section is completed or include a completed physical assessment form with this order form. HCPCS codes provided should not be considered as legal advice and do not guarantee reimbursement. DME providers are responsible for determining the appropriate billing codes when submitting for insurance reimbursement. Payer coding, coverage, and bundling guidelines may apply. All prices are MSRP. Prices, specifications, part numbers, and availability are subject to change without notice. Prices and part numbers as shown are only available when configured as a complete power chair. Please contact technical service for accurate parts ordering. Options noted with "XRef" have multiple possible part numbers based on system configuration. Please see cross-reference spreadsheet for the XRef part numbers. Thank you for choosing Quantum!
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Quantum Q6 Edge HD TRU-Balance 3 Seating Order Form · PDF fileDeep Purple Part: DGN169178-PPR5 Lime Light Part: DGN169178-PGN7 Grey Street Part: DGN169178-PSL3 Silver Bullet Part:
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Page 1 of 17INFINFB3572/RevF/01MAY2018
Q6 Edge® HD Order Form with TRU-Balance® 3 Positioning - Group 3
Quantum® Rehab401 York Ave., Duryea, PA 18642Phone: 866-800-2002 | Fax: 866-707-3422 | Email: [email protected]
A. Shoulder Width: _______B. Chest Width: _________C. Hip Width: ___________
D. Max Sitting Height: ____E. Shoulder Height: ______F. Axilla Height: _________
G. Thigh Depth: _________H. Lower Leg Length: ____I. Elbow Height: ________
INTRODUCTION This form is interactive when viewed with Adobe Acrobat Reader and may not function correctly if opened with applica-tions other than Acrobat. Complete the form by placing checks in the desired boxes and provide information in the interactive fields. Buttons shown at the bottom of the form may be utilized to print or submit the order form through a desktop email application. To email via a web-based application, please ‘Save As’ and attach the PDF to your email. This order form contains a large variety of options to fulfill various patient needs. Descriptions and section notes, such as optional or required, are included to help you complete your order. Please contact Quantum Sales at 866-800-2002 if assistance is needed. Send the completed order form by fax (866-707-3422) or email ([email protected]). Incomplete forms may delay the quote or order. Customer service will contact you if the order is incomplete or if there are compatibility issues. If special order requests are needed, be sure that the Patient Information section is completed or include a completed physical assessment form with this order form. HCPCS codes provided should not be considered as legal advice and do not guarantee reimbursement. DME providers are responsible for determining the appropriate billing codes when submitting for insurance reimbursement. Payer coding, coverage, and bundling guidelines may apply. All prices are MSRP. Prices, specifications, part numbers, and availability are subject to change without notice. Prices and part numbers as shown are only available when configured as a complete power chair. Please contact technical service for accurate parts ordering. Options noted with "XRef" have multiple possible part numbers based on system configuration. Please see cross-reference spreadsheet for the XRef part numbers.
Quantum Q6 Edge HD 3HD-SS ...............................$8,595Part: Q6 EDGEHD 3HD-SS. HCPCS: K0850Solid seat pan standard with no power option.
Quantum Q6 Edge HD 3SPHD-SS ............................$8,595Part: Q6 EDGEHD 3SPHD-SS. HCPCS: K0858Single power option.
Quantum Q6 Edge HD 3MPHD-SS ...........................$8,595Part: Q6 EDGEHD 3MPHD-SS. HCPCS: K0862Multiple power option.
BASE MOUNTED FOOT PLATFORMREQUIRED. Select a foot platform option. May interfere with seat mounted legrests. Not available with center mount foot platforms.
Base Mounted Foot Platform .............................StandardPart: FRMASMB160779.45"W x 10"D platform.
Base Mounted, Bell Shaped Foot Platform .......... No ChargePart: RIGASMB712004110.12"W tapering out to 14"W x 13.06"D platform.
Omit base mounted foot platform .................... No ChargePart: PTOINDV3674
DRIVE WHEELSREQUIRED. Select a type of drive wheels. Knobby tires increase overall base width by 1.5”.
3" x 14” Run Flat Tires ....................................StandardPart: PTOINDV3510
3" x 14” Flat Free Tires ................................. No ChargePart: WHL124116 x2
3" x 14” Pneumatic Tires ............................... No ChargePart: WHL124117 x2
BASE COLORREQUIRED. Select one shroud color. Colors shown here may differ from actual product depending on monitor/printer calibration used.
BASE MODELREQUIRED. Select a power base. 450 lb. weight capacity with standard 4.7 mph programmable motors, 8 amp off board charger, and unoccupied transit loops. Dimensions of base without legrests: 26”Wx36.75”L.
Red CorvettePart: DGN169178-PRD1
Electric BluePart: DGN169178-PBU9
Back in BlackPart: DGN169178-PBK1
White SatinPart: DGN169178-PWT2
Pretty in PinkPart: DGN169178-PPK3
Deep PurplePart: DGN169178-PPR5
Lime LightPart: DGN169178-PGN7
Grey StreetPart: DGN169178-PSL3
Silver BulletPart: DGN169178-PSL7
Midnight BluePart: DGN169178-PBU10
Orange CrushPart: DGN169178-POR6
Yellow BlazePart: DGN169178-PYL3
To Be DeterminedFollow-up required.
Match to Base Color ......................................$24.98 ea.Part: Configuration selection, see specific part below
Non-matching Color ......................................$24.98 ea.Part: Configuration selection, see specific part below
Red CorvettePart: DGN164245-PRD1
Electric BluePart: DGN164245-PBU9
Back in BlackPart: DGN164245-PBK1
White SatinPart: DGN164245-PWH2
Pretty in PinkPart: DGN164245-PPK3
Deep PurplePart: DGN164245-PPR5
Lime LightPart: DGN164245-PGN7
Grey StreetPart: DGN164245-PSL3
Silver BulletPart: DGN164245-PSL7
Midnight BluePart: DGN164245-PBU10
Orange CrushPart: DGN164245-POR6
Yellow BlazePart: DGN164245-PYL3
To Be DeterminedFollow-up required.
Drive Wheel Accent Color Optional. Sold in Pairs (parts below will be a quantity of 2). Not available with knobby tires.
Non-Expandable ControlsSelect a joystick below or omit selection if another controller type is desired. Non-expandable does not allow supplementary drive controllers.
NE 4-Key Joystick ........................... StandardPart: CTLDC1554Available with Static Seat or Tilt Only through Toggle.
NE+ 6-Key Joystick (1 Actuator) ........ No ChargePart: CTLDC1560Control of one actuator through Joystick on single power base model (3SPHD-SS) only.
No Joystick, Setup for NE+ Joystick ... No ChargePart: Configuration selection
NE+ 6-Key Joystick (2 Actuators) ............. $200Part: CTLDC1560Control up to 2 actuators through joystick.
NE+ 8-Key Joystick (2 Actuators) ............. $400Part: CTLDC1561Control up to 2 actuators and LED, Full Light Package through joystick.
ELECTRONICSREQUIRED. Select a type of drive control from the following sections. The No Joystick option is used to omit the joystick and utilize another control, such as a specialty control at the end of this form or found on the Alternative Controls and Electronics Order Forms.
Q-Logic 3 EX Controller Module ............... $695Part: See XRef. HCPCS: E2377
Q-Logic 3 EX Joystick ........................................... $700Part: CTL167724
Q-Logic 3 EX Joystick for LED, Full Light Package ........$700Part: CTL167725
No Joystick, Setup for Q-Logic 3Part: Configuration selection.
Q-Logic 3 Joystick
Fender Light Switch Mount Type
Expandable Controls - Quantum Intelligent Systems™Select expandable controls or omit selection if another controller type is desired. Expandable controls allow multiple or specialized controllers. This sections allows a selection of common configurations.
Q-Logic 3 Required ComponentsQ-Logic 3 expandable controls require the controller module and expandable harness below. If a Q-Logic joystick or specialty control is selected later in this form, Customer Service will quote the order with these items.
Q-Logic 3 Joystick ShroudREQUIRED with Q-Logic 3 EX Joystick selection above. Colors are shown on page 2. Price will be assigned to color part number.
Non-matching Shroud ............. $50Part: PTOINDV3422Select color below
Match Shroud ....................... $50Part: PTOINDV3421
Red CorvettePart: DGN124336-PRD1
Electric BluePart: DGN124336-PBU9
Back in BlackPart: DGN124336-PBK1
White SatinPart: DGN124336-PWH2
Pretty in PinkPart: DGN124336-PPK3
Deep PurplePart: DGN124336-PPR5
Lime LightPart: DGN124336-PGN7
Grey StreetPart: DGN124336-PSL3
Silver BulletPart: DGN124336-PSL7
Midnight BluePart: DGN124336-PBU10
Orange CrushPart: DGN124336-POR6
Yellow BlazePart: DGN124336-PYL3
Switch Operated Fender Lights....................................................................................................................$250*Part: DGN154117*Will be included at no charge with iLevel 10" Lift system. Fender lights operate by pressing included single switch button.
FENDER LIGHTINGOptional. Fender lighting is not available with NE 4-Key joystick or Single Actuator Control through Toggle Box.
FULL LIGHT PACKAGESOptional. Requires NE+ 8 Key or Q-Logic 3 Joystick for Full Light Package.
Seat Mounted, LED, Full Light Package ........................................................................................................... $995Part: ELE131477
Q-Logic 3 EX Joystick
Side Rail/Track Mount Bracket ......................... No ChargePart: MEC1800866Allows the egg switch to be mounted to seating side rails using a t-nut assembly. This may also be mounted to TRU-Balance 3 flip-back arm-rest and other seat or accessory bar rails. Not available with con-toured seating.
Under Armrest Mounting Bracket ............................ $50*Part: MEC1802726*No charge with contoured seating. Allows the egg switch to mount to a joystick tube-style bracket mounted to any armrest. Includes joystick mounting bracket.
JOYSTICK HANDLESOptional. The NE/NE Plus joysticks are standard with a carrot handle (See A in image). The standard Q-Logic 3 joystick knob can be seen in the image on the previous page. The optional handle will be mounted to the joystick and the standard handle will be shipped with the unit.
SCIM Module Kit for Q-Logic 3 ........................................................................................$525Part: CTL168055Allows use of joystick display for specialty devices. Available with Q-Logic 3 EX Joystick selection above. Up to 5 profiles to control drive, seat, and auxiliary functions, excluding sip-n-puff and single switch functions. A switch is required to operate the input device attached to the SCIM module. SCIM Module
Bodypoint 3” Goal Post Handle .................. $99Part: PLSKNCP1057. HCPCS: E2323
Bodypoint 4” Goal Post Handle .................. $99Part: PLSKNCP1058. HCPCS: E2323
Q-Logic 3 Carrot Handle (A) ............. No ChargePart: DGN124308
JOYSTICK MOUNTING BRACKETSREQUIRED. Select a mount to be used with a joystick selected in previous section.
Omit Joystick Mounting Bracket
Fixed, Inline Joystick Bracket
Swing Away JoystickInline Mount (Right)
Swing Away JoystickOffset Mount (Right)Swing-away, Inline, Left Side Mount .......... $245
Part: See XRef. HCPCS: E1028
Swing-away, Inline, Right Side Mount ........ $245Part: See XRef. HCPCS: E1028
Swing-away, 1” Offset, Left Side Mount ..... $245Part: See XRef. HCPCS: E1028
Swing-away, 1” Offset, Right Side Mount .... $245Part: See XRef. HCPCS: E1028
Swing-Away (Retractable) BracketAllows the joystick to retract to the side of the armrest while maintaining the same joystick orientation. "Inline brack-et" is used with TRU-Balance 3 arms when the joystick is inline with armpad. "Inline bracket" will be offset 1" when used with tube style arms. Select "Offset Bracket" to have the joystick inline with armpad on tube style armrests.
Retract4 Mount ................................... $350NE/NE+ Part: MEC138876. HCPCS: E1028Q-Logic Part: MEC138860. HCPCS: E1028Full 180° of movement that translates into multi-position use, straight, right offset, left offset, or fold away. Joy-stick orientation varies as bracket is adjusted.
Multi-axis Mount ...................................$100NE/NE+ Part: ACC142528. HCPCS: E1028Q-Logic Part: ACC131216. HCPCS: E1028Allows height adjustment of joystick.
Stealth Swing-Away/Flip Down Bracket ....$294.25SAJ Part: ST-TWBM480CJ-Q. HCPCS: E1028Q-Logic Part: ST-TWBM480QL-Q. HCPCS: E1028Allows the joystick to pivot to side of armrest, or flip-down if bracket is adjusted.
Specialty Joystick MountsSelect a bracket and side to mount it.
USB Mobile Device Charger ......................$175Part: ELE168069Can charge 1 device. A multiplier harness is required and must be added when a Static Seat or Power Tilt Only seating system is chosen. The selection of more than 3 modules requires an additional multiplier.
Q-Logic PC Programming Disk with Cable ... $750Part: ELEASMB5216 USB Media
Device Charger
TRU-BALANCE® 3 SEATING - Quantum Intelligent Systems™REQUIRED. Select one seating system. Be sure to complete the Seat Dimension, Seat to Floor, and back selections.
TRU-Balance 3 Static Seat ...................................$2,295Part: PTOINDV344220° of limited recline adjustment (-5/ +15) via gas strut within back cover.
TRU-Balance 3, Heavy Duty, Power Tilt ..................$7,995Part: PTOINDV3643. HCPCS: E100250° Center of Gravity (CG) power tilt seating system.
TRU-Balance 3 Heavy Duty, Power Recline ..............$8,595Part: PTOINDV3645. HCPCS: E1004175° of power recline.
TRU-Balance 3 Heavy Duty, Power Tilt & Recline .... $12,895Part: PTOINDV3644. HCPCS: E100750° CG power tilt with 175° of power recline. Full drive lockout at 20°.
TRU-Balance® 3 Configuration
TRU-Balance 3, Heavy Duty, 10” Power Lift with iLevel® and Fender Lights ............................ $2,600Part: PTOINDV3797. HCPCS: E2300400 lb weight capacity. 24”W x 24”D maximum seat size. Includes fender lights found on page 2.
10” Power Lift - iLevel SystemOptional. Select one option below.
Seat DimensionsREQUIRED with seat selection. Select width and depth package and enter desired set width and depth in that available package range, available in 1” increments. Configurations disallowed or not shown may be available through special order. Maximum non-lift seat size is 32"W x 25"D. Maximum lift seat size is 24"Wx25"D. Seat depth of 25" D is attainted by using the 20"-24" Depth Package. Parts: See XRef: TB3SPACK
16”-20” Depth PackageMinimum Seat Depth is 20"
20”-24” Depth PackageUse with 25" Depth
Not available with power lift:
20” D(#1010)
21” D(#1011)
22” D(#1012)
23” D(#1013)
24” D(#1014)
25” D(#1060)
20” W(#1010)
21” W(#1011)
22” W(#1012)
23” W(#1013)
24” W(#1014)
25” W(#1056)
26” W(#1054)
27” W(#1057)
28” W(#1055)
29” W(#1058)
30” W(#1059)
31” W(#1060)
32” W(#1061)
Set Width at:______ Part: SETWDTH#, see below
Set Depth at:______ Part: SETDPTH#, see below
Static Seat Only or Recline Only
Tilt Only, Tilt and Recline, or Any Power Lift Configuration
Seat to Floor HeightREQUIRED. Select a seat to floor height compatible with the seat functions previously selected.
Back Cane TypeSelect with Back Cane Option selected above.
Back SelectionREQUIRED. Match choice in this section with the options in the back cushion configuration section.
TRU-Balance 3 Back Assembly (Static Back)Part: Configuration selectionSelect a back cushion configuration in the subsequent section.
Back Cane OptionPart: Configuration selectionAvailable only with TRU-Balance 3 Static Seat and Power Tilt (1 actu-ator) selections. Select back cane type, back cane height, and back cushion configuration.
Back Cane HeightSelect with Back Cane Option selected above.
16”High CanePart: FRMASMB15834
17”High CanePart: FRMASMB15835
20”High CanePart: FRMASMB15838
21”High CanePart: FRMASMB15839
24”High CanePart: FRMASMB15842
25”High CanePart: FRMASMB15843
Sport Back.................................................. No ChargePart: See XRefComplete following width package and size.
TRU-Comfort 2 Back, 20” Width or less .................... $675Part: See XRef. HCPCS: E2620Complete following width package and size.
TRU-Comfort 2 Back, 22” Width or greater ............... $775Part: See XRef. HCPCS: E2621Complete following width package and size.
Omit Back Pan/Cushion .................................. No ChargePart: PTOINDV1287Select a following width package.
After-market Back Interface ..................................$200Part 16"-20"W: SET131920. Part 20"-24"W: SET131921Enter the set width below, range of 16"-24". Overall seat depth may need to be adjusted to accommodate certain backs. May interfere with gel/waterfall armpads and arm through. Does not include brack-ets to mount after-market backs. A Special Order is required on back widths less than 16”.
Back Cushion ConfigurationREQUIRED. Select a configuration type and applicable dimensions. See the Sport, Q-Back, and TRU-Comfort 2 back availability chart for stock order back size ranges. Other size backs may be available with Special Order and extended lead time.
Match Seat Width SelectionsPart: PTOINDV3468
16”W-20”W PackagePart: Configuration selection, back cushions
20”W-24”W PackagePart: Configuration selection, back cushions
24”W-28”W PackagePart: Configuration selection, back cushions
28”W-32”W PackagePart: Configuration selection, back cushions
Back Cushion WidthAvailable with +/-4” of seat width. Reference chart for available back width.
Tilt or Static Back Width Recline Back Width
Sport and TRU-Comfort 2 Back Availability Chart
Ove
rall
Back
Hei
ght
Sport or TRU-Comfort 2 BackSport Back
Set Back Width at:______ Part: PTOINDV#, see below
Back Cushion Overall HeightStatic Seat and Power Tilt available height range: 16”-25”H. Odd heights include 4” gap and even heights include 3” gap between seat pan and bottom of back cushion. Power Recline available height range: 19”-28”H. Odd heights include 6” gap and even heights include 7” gap. See the Sport and TRU-Comfort 2 back availability chart for stock order back size ranges.
Set Overall Height at:______ Part: SETHGTH#, see below
16” High(#1029)
17” High(#1030)
18” High(#1031)
19” High(#1032)
20” High(#1033)
21” High(#1034)
22” High(#1035)
23” High(#1036)
24” High(#1037)
25” High(#1038)
26” High(#1039)
27” High(#1040)
28” High(#1041)
TRU-Balance 3 Back ShroudREQUIRED. The back shroud is a feature of the TRU-Balance 3 seating system and is available in matching shroud colors. The back shroud is not available with the back cane configuration. Reference colors shown on page 2.
Back in BlackPart: DGN148032
Red CorvettePart: DGN148034
Electric BluePart: DGN148076
White SatinPart: DGN148075
Pretty in PinkPart: DGN148045
Deep PurplePart: DGN148046
Lime LightPart: DGN148036
Grey StreetPart: DGN148074
Silver BulletPart: DGN148047
Midnight BluePart: DGN148035
Orange CrushPart: DGN148038
Yellow BlazePart: DGN148077
Additional TRU-Balance 3 Back OptionsOptional.
TRU-Comfort Lateral Positioning Wedge, pair ..............$30Part: SET123465Available with TRU-Comfort backs. Not available on power tilt backs 16”-17”H with limited adjustability on 18” H. Not available on power recline back 19”-20”H with limited adjustability on 21”H.
See Comfort Company Back order form
Privacy Flap, 9.75” ................................................$35Part: DWR1044E456BStandard on recline seating systems.
Privacy Flap, 12.75” ..............................................$35Part: DWR1044E456AStandard on recline seating systems.
Heavy Duty, Removable ArmrestsSelect a type of HD removable armrests and the set height in the following section. Only one height package is selectable as a normal config-uration.
8”-12”H, Single Post, Height Adjustable, ...............$75 ea.Removable, Heavy Duty (Sold as pair) Part: See XRef. HCPCS: E0973
10”-14”H, Single Post, Height Adjustable, ..............$75 ea.Removable, Heavy Duty (Sold as pair) Part: See XRef. HCPCS: E0973
TRU-Balance 3 Flip-Back, 8”-12”H ..................StandardPart: See XRef
TRU-Balance 3 Flip-Back, 12”-16”H ................StandardPart: See XRef
ARMRESTSREQUIRED. Select the desired type of armrest below. Please read notes to ensure seating compatibility. Be sure to also select an armrest size and armpad type.
TRU-Balance 3 Flip-Back ArmrestsChoose a left and right TRU-Balance 3 armrest and set height in the following section. An optional downpost is also available. Different Left (L) and Right (R) armrest height packages are allowed. Not available with Back Cane Option.
TRU-Balance 3 Armrest Downpost (Pair) .................................................................................................. No ChargePart: See XRefAvailable up to 2” difference between seat and back width via endomorph or mesomorph configuration. Not available on 14” Width seat or back.
ARMREST SIZEREQUIRED. Select a Left (L) and Right (R) armrest size. This also affects the foam and waterfall armpad selection below.
No Armpad Selection and/or See Positioning Components Page or Order Form ................................................. No ChargePart: Configuration selection
Straight, Armpad .......................................StandardPart: See XRef
Waterfall, Armpad .................................... No ChargePart: See XRef
ARMPADSREQUIRED. Select to omit an armpad selection or select a left and right armpad type. Please note that waterfall and gel armpads may cause interference with the seat back.
Foam Armpads
Falcon Gel Armpads for TRU-Balance 3 Armrests
Falcon Gel Armpads for Tube Style Arms
Falcon Gel, Full Length Left and Right ...................... $185Part: ARM136417
Falcon Gel, Full Length Left, Desk Length Right ...... $162.50Part: ARM136426
Falcon Gel, Desk Length Left, Full Length Right ...... $162.50Part: ARM136418
Falcon Gel, Desk Length Left and Right .................... $140Part: ARM136416
Falcon Gel, Full Length Left and Right ..................$296.40Part: ARM136438
Falcon Gel, Full Length Left, Desk Length Right ...... $274.22Part: ARM136442
Falcon Gel, Desk Length Left, Full Length Right ...... $274.22Part: ARM136439
Falcon Gel, Desk Length Left and Right ................$252.40Part: ARM136437
Gel ArmpadsSold only in pairs. Armpads are 3” wide.
Height AdjustableReceiver (Track Arm)
Height AdjustableReceiver (Tube Arm)
JOYSTICK BRACKET RECEIVERREQUIRED.
Standard Fixed Receiver ..................................StandardPart: ACC123525
Stealth Height Adjustable Receiver .......................... $214Tube Arm Part: ST-ARM250C-Q. HCPCS: K0108Track Arm Part: ST-ARM250T-Q. HCPCS: K0108
ARMREST HEIGHTREQUIRED. Set left and right armrest height. Note the available height range in the option description.
Set Left Height at:______ Set Right Height at:______ 8” HighPTOINDV3535
Push Handles (pair) ...............................$175Part: ACC147772Not available with oxygen holder, back cane option, or vent tray. Required with attendant manual recline.
Accessory Bar ......................................$100Part: MEC125098Standard with the Trilogy vent tray, and oxygen holder. May be added to mount additional accessory to back of unit. Not available with back cane option.
POWER LEGREST CONTROLOptional. Specific power legrest options are selected later in this form. Select the control type here, if power legrests are desired, to assist the selection of the power positioning electronics.
POWER POSITIONING ELECTRONICSREQUIRED, except with Static Seat without power options. Select the desired control type for the seating system. Please note the available actuator controls. The 4-way toggle and 4 function push button are mounted on the same side as the joystick.
Single Actuator Control Through Flat Button ............$3,295iAccess and Q-Logic 3 Controller and InterfaceOnly available with TRU-Balance 3 armrests. Part: See XRef. HCPCS: E2310
Multiple Actuator Control Through Flat Button .........$3,295iAccess and Q-Logic 3 Controller and InterfaceOnly available with TRU-Balance 3 armrests. Part: See XRef. HCPCS: E2311
Single Actuator Control Through Toggle Button ........$3,295iAccess and Q-Logic 3 Controller and InterfaceOnly available with TRU-Balance 3 armrests. Part: See XRef. HCPCS: E2310
Multiple Actuator Control Through Toggle Button ......$3,295iAccess and Q-Logic 3 Controller and InterfaceOnly available with TRU-Balance 3 armrests. Part: See XRef. HCPCS: E2311
Single Actuator Through Q-Logic 3 ........................$1,895Controller and Interface Part: See XRef. HCPCS: E2310
Multiple Actuator Through Q-Logic 3 .....................$2,895Controller and Interface Part: See XRef. HCPCS: E2311
Single Actuator Control Through ...........................$1,895NE+ 6-Key Joystick Part: See XRef. HCPCS: E2310
Two Actuator Control Through .............................$2,895NE+ 6-Key Joystick Part: See XRef. HCPCS: E2311
Single Actuator Control, Through Toggle (Power Tilt Only) .............................................No ChargePart: See XRefOnly available with Power Tilt only. Manual recline is not available with NE Tilt through toggle. Fender lights are not available with tilt through toggle. Select toggle side.
Left Side Toggle Right Side TogglePart PTOINDV1838 Part: PTOINDV1839
Q-Logic 3 Controls with iAccess Switch ControliAccess control is not available with combined or independent power legrests.
Tilt Only through Toggle
NE+ 6-Key Controls
Q-Logic 3 Controls through Joystick
Switch Controls
iAccessFlat Button
iAccessToggle Button
Left Side iAccess Right Side iAccessPart PTOINDV3678 Part: PTOINDV3679
iAccess Mount
ATTENDANT CONTROLOptional. *Attendant control will be at no charge when ordered with Tilt and Recline, alternative drive controls, and a Q-Logic Display or SCIM module. Mounting bracket is included.
Attendant Control ..............................................$500*Part: ELE167862. HCPCS: E2331
Page 11 of 17INFINFB3572/RevF/01MAY2018
This rigging configuration causes no interference issues at this seat-to-floor height.This rigging configuration may have less than 1.75” clearance when fully extended and may interfere with the ground or reduce obstacle climbing ability.
Center Mount Foot Platform Compatibility Matrixfor TRU-Balance® 3
Power Reclineor Static Seat
Low Med. High Low Med. High Low Med. High
Power Tilt Power Lift
10”-16” Length Extension
13”-19” Length Extension
LEGRESTSOptional. All efforts will be made to accommodate legrest length selection, but minor changes may need to be made to meet shipping guide-lines. Some adjustments may be needed upon receipt of the unit. Reference the section’s compatibility matrix for legrest interference.
Small Calf Pads (pair) 6”Wx6”H ............................... $150*Part: RIGASMB7120018
Large Calf Pads (pair) 8” taper to 6”Wx8”H ............... $150*Part: RIGASMB7120019
Small Calf Panel 18”Wx8”H ................................... $150Part: FRMASMB7110012
Large Calf Panel 24”Wx8”H ...................................$200Part: RIG123824Only available on widths of 20” or greater.
Width Extension for 8”D Footplates ..........................$50Part: RIG152517
Width Extension for 11”D Footplates .........................$50Part: RIG152518
2” Bell-Shaped Length Extension ..............................$50Part: RIG152519Not compatible with width extensions. Can be used with 6” outside edge with 11” footplates.
4” Outside Edge (pair) ............................................$50Part: RIG152510Only available with 6”D footplates and 8”D footplate extension.
6” Outside Edge (pair) ............................................$50Part: RIG152516Available with 8”D and 11”D footplates and 11”D footplate extension.
Reversed Dartex Calf Pad Cover (pair) ...................... $150Small part: RIG133717. Large part: RIG133719
Center Mount Calf Support*Calf pads are standard with a power articulating foot platform. Select calf pads covers for additional charge. Calf pad and panel covers include 1/2” of soft visco foam.
Modular Footplate Extension ComponentsOptional. Assembly required. May require seating configuration adjustments to avoid front caster interference.
Additional Accessories
Center Mount Foot PlatformsIf power articulating foot platform is selected, be sure power legrest control has been selected in previous section. Select legrest length in following section.
8"-12" Extension, 5"x6" FootplatesPart: RIG152577Not available with power articulating platform.
8"-12" Extension, 5"x8" FootplatesPart: RIG152578Not available with power articulating platform.
Heavy Duty, 70°, Drop-In, Swing-Away LegrestsSelect a configuration, a legrest with extension, and type of footplate. Pair (P), left (L), and right (R) configurations are selected by checking the appropriate boxes.
Accessories
Heavy Duty Elevating LegrestsSelect a configuration, a legrest upper, a legrest extension, and type of footplate. Left (L) and right (R) configurations are selected by checking the appropriate boxes.
Left and Right Legrests will match Left and Right Legrests will not match One Legrest (Left or Right as Marked)
6”Wx11”D1 .............................................$85 ea.Pair part: FRMASMB4741. Left: RIG137796. Right: RIG137797.HCPCS: K0040May cause interference on seat widths less than 18".
8”Wx11”D2 .............................................$85 ea.Pair part: FRMASMB4744. Left: RIG137708. Right: RIG137709.HCPCS: K0040May cause interference on seat widths less than 20".
Wheel Bumper(s) ...................................................................................................................... $12.50 ea.Pair part: WHLASMB1578. Left part: WHL169510. Right part: WHL169511
Angle Adjustable Footplate(s) with Heel Loops
Heavy Duty, Elevating Legrest(s) with Calf Pad(s) .............................................................................$162.50 ea.Pair part: FRMASMB6702. Left: FRMASMB8444. Right: FRMASMB8445. HCPCS: E0990
8”Wx11”D ..............................................$85 ea.Pair part: FRMASMB4744. Left: RIG137798. Right: RIG137799.HCPCS: K0040May cause interference with seat widths less than 20"
Angle Adjustable Footplate(s) with Heel Loops
11”-14” LengthPart: FRMASMB4755. Left part: RIG138026. Right part: RIG138030For reinforced footplates only.
12”-14.5” LengthPart: FRMASMB4752. Left part: FRMASMB5391. Right part: FRMASMB4723For angle adjustable footplates only.
14”-17” LengthPart: FRMASMB4756. Left part: RIG138033. Right part: RIG138035For reinforced footplates only.
14.5”-18” LengthPart: FRMASMB4753. Left part: FRMASMB4724. Right part: FRMASMB5392For angle adjustable footplates only.
Lower Extension
Page 13 of 17INFINFB3572/RevF/01MAY2018
SET LEGREST LENGTHREQUIRED with matching left and right legrest configuration. All efforts will be made to accommodate legrest length selection, but minor changes may need to be made to meet shipping guidelines. Some adjustments may be needed upon receipt of the unit. Reference the section’s compatibility matrix for legrest interference. Non-matching or individual legrest configurations lengths are not set by the manufacturer.
Set Legrest Length at:______ Part: PTOINDV#, see below
CUSHION QUICK PICKOptional. Specific cushion/component sizes available, part numbers, and special order cushions can be found on the complete Stealth Cushion Order Form.
PROVIDER INSTALLED ACCESSORIESOptional. Multiple accessories can be mounted along the various tracks but some interference may occur.
TRU-Balance 3Accessories
TRU-Balance 3 Cup Holder .............. No ChargePart: ACC125003For use with TRU-Balance 3 (track style) armrests.
Cup Holder (Tube-style Armrest) ...... No ChargePart: ACCASMB2634For use with tube-style armrests.
TRU-Balance 3 Backpack Holder (Pair) (A) .... $50Part: ACC147774Not available with back cane option.
TRU-Balance 3 Hydration System (B) ......... $200Part: ACC125010
BATTERIESREQUIRED. Select a type of battery below or to omit the batteries. The powerchair requires 2 batteries. Batteries will be installed if ordered.
Group 24, 70 Amp Gel Cell, Interceptor Battery .... $365 ea.Part: BAT1704614. HCPCS: E2363
No batteries. Provider will assume responsibility of batteries.Part: Configuration selection
Group 24, 70 Amp Gel Cell, MK Battery ............... $410 ea.Part: BATGEL1009. HCPCS: E2363
BRANCH PATCHESOptional.
Air Force Army Coast Guard Marines Navy Purple Heart
MANUFACTURER INSTALLED POSITIONING COMPONENTSOptional. More options are available on the Positioning Components Order Form.
Stealth Thoracic LateralsSwing-away laterals may interfere with TRU-Balance 3 and 2-post, flip up armrests. These laterals are not available with the back cane option.
Removable Bracket with 1” Offset .................$400 ea. (LP430 & LHW-121)
Part: INDPART2854. HCPCS: E1028
Stealth Pelvic/Thigh GuidesPelvic/thigh guides may interfere with the joystick receiver block and down posts. Please provide quantity next to check box.
Bracket
Air Force Patch .....................................................$20Part: ACC140240
Army Patch ..........................................................$20Part: ACC140241
2” Height Adapter Plate (LHW-122) ........................$26.25Part: INDPART2821. HCPCS: K0108Height adapter is needed with TRU-Comfort seat cushions. Not avail-able with the flip down bracket.
2 1/4” Adapter Plate (LHW-129) ............................$53.50Part: POS140430. HCPCS: K0108Only available with the flip down full surface bracket.
Short Pad, 4”x4” (TWBADD-4X4) .....................$75 ea.Part: INDPART2801. HCPCS: E0953^
Medium Pad, 4”x8” (TWBADD-4X8) ..................$75 ea.Part: INDPART2802. HCPCS: E0953^
Long Pad, 4”x12” (TWBADD-4X12) ...................$75 ea.Part: INDPART2803. HCPCS: E0953^
Install on LeftPart: PTOINDV3585
Install on RightPart: PTOINDV3586
Do Not InstallPart: PTOINDV3719
Pelvic/Thigh Guide Pad^ Please verify the appropriate billing code to be used for this item with all third party payors.
Pelvic/Thigh Guide Adapter
Pelvic/Thigh Guide Installation
MANUFACTURER INSTALLED POSITIONING COMPONENTS continued
NON-INSTALLED POSITIONING COMPONENTSOptional. More options are available on the Positioning Components Order Form.
Q-Logic 3 SAJQ-Logic 3 EX SAJ ........................................................................................................$700Part: CTL143980Must be used in conjunction with Enhanced Display or Q-Logic 3 Joystick.
SPECIALTY CONTROLSOptional. Select a type of specialty controls below or to refer to the specialty controls order form.
Non-matching Joystick Shroud .................. $50Select color below
Match Joystick Shroud to Base Color ........... $50Part: See color below.
Q-Logic 3 Enhanced Display ShroudRequired with Q-Logic 3 Enhanced Display selection above. Reference colors shown on page 2.
Q-Logic 3 Enhanced Display Kit ................................................................................... $1,720Part: CTL167726Select a color option below. Includes enhanced display, flexible gooseneck and mounting bracket. Features: 3.5” LCD display; up to 5 profiles to control drive, seat, and auxiliary functions; Bluetooth connectivity for mobile devices and mouse emulation; integrated single switch scanner; IR controls.
Enhanced Display
NON-INSTALLED POSITIONING COMPONENTS continued
Facial Lateral, 4.5"x2" Pad, Right Side, ................ $294.25for Comfort Series (CPS9-R-HW)Part: INDPART2647. HCPCS: E1028
Facial Lateral, 4.5"x2" Pad, Left Side ................... $294.25for Comfort Series (CPS9-L-HW)Part: INDPART2648. HCPCS: E1028
Facial Lateral, 4.5"x2" Pads, Left and Right Side .. $347.75 ea.for Comfort Series (CPS9-B-HW)Part: INDPART2649. HCPCS: E1028
Stealth Swing Away Headrest MountsThese Swing-Away headrest mounts are only available with the Stealth Comfort Series Headrests.
Other Accessories
Stealth HeadrestMounts
Head ArrayAdult, i-Drive Tri-Array Series, 3-Switch .. $4,414Head Array (IDHBT200-1)Part: ST-IDHBT200-1-Q. HCPCS: E2330Features bluetooth, head support, 3 non-proportional proximity sensors for drive control, an egg switch for re-set mode change, and i-Drive smart box.
Adult, i-Drive Pro Series Head Array ....... $4,461(IDHBT300-1)Part: ST-IDHBT300-1-Q. HCPCS: E2330Features bluetooth, head support with occipital pad and 2 swing-away spot pads for left and right side, 3 non-pro-portional proximity sensors, an egg switch for reset mode change, and i-Drive smart box.
Adult Pro-Series
1" Ball Kit for Facial Laterals (TWB-1BK)...$80.25Part: POS150532Required with facial laterals to mount to comfort head-rest brackets.
Egg Switch Mount (ESM) (A) ......... $52.50 ea.Part: INDPART2815
Figure 8 Bracket with 13" Rod .....$267.50 ea. and Egg Switch Mount (B)
Special Order Configuration (SOF)Part: Configuration selection
MULTIPLIER HARNESSREQUIRED. Multiple controllers or power accessories may require an additional multiplier harness or special order. Reference the chart be-low to determine the appropriate selection. The rows refer to the to-tal amount of arm mounted devices and the columns refer to the total amount of back mounted devices. The online order configurator will automatically make this selection under specialty controls.
REFERENCE ORDER FORMSOptional. Select below to note that additional order forms will accompany this order form. This will also be a link in interactive forms.
1 Arm 2 Arm 3 Arm 4+ Arm
1 Back0 Back
2 Back3+ Back
NANASMSOF
SMSMSMSOF
SMSMSMSOF
SOFSOFSOFSOF
Power Positioning Chart
1 Arm 2 Arm 3 Arm 4+ Arm
1 Back0 Back
2 Back3+ Back
NA
NA No additional MultiplierSecondary MultiplierSpecial Order Required
NASM
SM SOFSOF
SMSMSMSOF
SOFSOFSOFSOF
SOFSOFSOFSOF
Static Seat Chart
Q-Logic 3 Multiplier Charts
Arm
Mou
nts Joystick (Hand Control)
Enhanced DisplayiAccessUSB ChargerSAJ
Back
Mou
nts
Attendant ControlSCIMSip n PuffECU
Stealth Sip and Puff for Comfort Series, .... $294.25Left Mount(SP625-CL)Part: ST-SP625-CL-Q Includes straw and mounting hardware. Use with Stealth Comfort Plus headrests.
Stealth Sip and Puff for Comfort Series, .... $294.25Right Mount (SP622-CR)Part: ST-SP625-CR-QIncludes straw and mounting hardware. Use with Stealth Comfort Plus headrests.
Stealth Sip and Puff for Stealth Ultra, .....$294.253-Switch Head Array (SP625-U)Part: ST-SP625-U-Q Includes straw and mounting hardware. Use with Stealth Ultra Head Array, CTLDC1192, found on Alternative Con-trols and Electronics order form. Stealth Sip & Puff
Straw and Mount
Sip and Puff Module for Q-Logic 3 .................................................................................$1,895Part: CTL168056 Includes module and mounting hardware.
Option Name MSRP Part Number Manufacturer Extended DescriptionELECTRONICSQ-Logic 3 EX Controller Module $695 ELE1705058 ELECTRONIC,ASSY,Q-LOGIC 3,64 HAMMER II MOTORS,Q6EDGE HD,STATIC SEATING
ELE1705059 ELECTRONIC,ASSY,Q-LOGIC 3,64 HAMMER II MOTORS,Q6EDGE HD,STATIC SEATING,W/POWER
ELE1705060 ELECTRONIC,ASSY,Q-LOGIC 3,64 HAMMER II MOTORS,Q6EDGE HD,POWER POSITIONING
ELE1705061 ELECTRONIC,ASSY,Q-LOGIC 3,64 HAMMER II MOTORS,Q6EDGE HD,STATIC SEATING,W/PTO
ELE1705062 ELECTRONIC,ASSY,Q-LOGIC 3,64 HAMMER II MOTORS,Q6EDGE HD,STATIC SEATING,W/POWER,W/PTO
ELE1705178 ELECTRONIC,ASSY,Q-LOGIC 3,64 HAMMER II MOTORS,Q6EDGE HD,TILT THRU TOGGLE,W/PTO
ELE1705063 ELECTRONIC,ASSY,Q-LOGIC 3,64 HAMMER II MOTORS,Q6EDGE HD,POWER POSITIONING,W/PTO
JOYSTICK MOUNTING BRACKETSSwing-away, Inline, Left Side Mount $245 ACC142526 JOYSTICK MOUNTING BRACKET,ASSY,SWING AWAY,INLINE,LEFT,NE/NE PLUS
ACC142524 JOYSTICK MOUNTING BRACKET,ASSY,SWING AWAY,INLINE,LEFT,Q-LOGIC Swing-away, Inline, Right Side Mount $245 ACC142527 JOYSTICK MOUNTING BRACKET,ASSY,SWING AWAY,INLINE,RIGHT,NE/NE PLUS
ACC142525 JOYSTICK MOUNTING BRACKET,ASSY,SWING AWAY,INLINE,RIGHT,Q-LOGIC Swing-away, 1" Offset, Left Side Mount $245 ACC142747 JOYSTICK MOUNTING BRACKET,ASSY,SWING AWAY,OFFSET,LEFT,NE/NE PLUS
ACC142525 JOYSTICK MOUNTING BRACKET,ASSY,SWING AWAY,OFFSET,LEFT,Q-LOGICSwing-away, 1" Offset, Right Side Mount $245 ACC142748 JOYSTICK MOUNTING BRACKET,ASSY,SWING AWAY,OFFSET,RIGHT,NE/NE PLUS
TRU-Comfort 2 Back, 20" Width or less $675 SET123631 SEAT BACK,ASSY,16"W,16"W-20"W,13"H,TRU-COMFORT 2,4 WAY STRETCHSET123633 SEAT BACK,ASSY,16"W,16"W-20"W,15"H,TRU-COMFORT 2,4 WAY STRETCHSET123635 SEAT BACK,ASSY,16"W,16"W-20"W,17"H,TRU-COMFORT 2,4 WAY STRETCHSET123637 SEAT BACK,ASSY,16"W,16"W-20"W,19"H,TRU-COMFORT 2,4 WAY STRETCHSET123639 SEAT BACK,ASSY,17"W,16"W-20"W,13"H,TRU-COMFORT 2,4 WAY STRETCHSET123641 SEAT BACK,ASSY,17"W,16"W-20"W,15"H,TRU-COMFORT 2,4 WAY STRETCHSET123651 SEAT BACK,ASSY,17"W,16"W-20"W,17"H,TRU-COMFORT 2,4 WAY STRETCHSET123653 SEAT BACK,ASSY,17"W,16"W-20"W,19"H,TRU-COMFORT 2,4 WAY STRETCHSET123655 SEAT BACK,ASSY,18"W,16"W-20"W,13"H,TRU-COMFORT 2,4 WAY STRETCHSET124576 SEAT BACK,ASSY,18"W,16"W-20"W,15"H,TRU-COMFORT 2,4 WAY STRETCHSET124578 SEAT BACK,ASSY,18"W,16"W-20"W,17"H,TRU-COMFORT 2,4 WAY STRETCHSET124597 SEAT BACK,ASSY,18"W,16"W-20"W,19"H,TRU-COMFORT 2,4 WAY STRETCHSET124599 SEAT BACK,ASSY,18"W,16"W-20"W,21"H,TRU-COMFORT 2,4 WAY STRETCHSET124601 SEAT BACK,ASSY,19"W,16"W-20"W,13"H,TRU-COMFORT 2,4 WAY STRETCHSET124602 SEAT BACK,ASSY,19"W,16"W-20"W,15"H,TRU-COMFORT 2,4 WAY STRETCHSET124603 SEAT BACK,ASSY,19"W,16"W-20"W,17"H,TRU-COMFORT 2,4 WAY STRETCHSET124605 SEAT BACK,ASSY,19"W,16"W-20"W,19"H,TRU-COMFORT 2,4 WAY STRETCHSET124606 SEAT BACK,ASSY,20"W,16"W-20"W,13"H,TRU-COMFORT 2,4 WAY STRETCHSET124607 SEAT BACK,ASSY,20"W,20"W-24"W,13"H,TRU-COMFORT 2,4 WAY STRETCHSET124609 SEAT BACK,ASSY,20"W,16"W-20"W,15"H,TRU-COMFORT 2,4 WAY STRETCHSET124610 SEAT BACK,ASSY,20"W,20"W-24"W,15"H,TRU-COMFORT 2,4 WAY STRETCHSET124611 SEAT BACK,ASSY,20"W,16"W-20"W,17"H,TRU-COMFORT 2,4 WAY STRETCHSET124612 SEAT BACK,ASSY,20"W,20"W-24"W,17"H,TRU-COMFORT 2,4 WAY STRETCHSET124613 SEAT BACK,ASSY,20"W,16"W-20"W,19"H,TRU-COMFORT 2,4 WAY STRETCHSET124618 SEAT BACK,ASSY,20"W,20"W-24"W,19"H,TRU-COMFORT 2,4 WAY STRETCHSET124619 SEAT BACK,ASSY,20"W,16"W-20"W,21"H,TRU-COMFORT 2,4 WAY STRETCHSET124623 SEAT BACK,ASSY,20"W,20"W-24"W,21"H,TRU-COMFORT 2,4 WAY STRETCH
TRU-Comfort 2 Back, 22" Width or greater $775 SET124624 SEAT BACK,ASSY,22"W,20"W-24"W,13"H,TRU-COMFORT 2,4 WAY STRETCHSET124625 SEAT BACK,ASSY,22"W,20"W-24"W,15"H,TRU-COMFORT 2,4 WAY STRETCHSET124626 SEAT BACK,ASSY,22"W,20"W-24"W,17"H,TRU-COMFORT 2,4 WAY STRETCHSET124627 SEAT BACK,ASSY,22"W,20"W-24"W,19"H,TRU-COMFORT 2,4 WAY STRETCHSET124628 SEAT BACK,ASSY,24"W,20"W-24"W,13"H,TRU-COMFORT 2,4 WAY STRETCHSET130059 SEAT BACK,ASSY,24"W,24"W-28"W,13"H,TRU-COMFORT 2,4 WAY STRETCHSET124629 SEAT BACK,ASSY,24"W,20"W-24"W,15"H,TRU-COMFORT 2,4 WAY STRETCHSET130060 SEAT BACK,ASSY,24"W,24"W-28"W,15"H,TRU-COMFORT 2,4 WAY STRETCHSET124630 SEAT BACK,ASSY,24"W,20"W-24"W,17"H,TRU-COMFORT 2,4 WAY STRETCHSET130061 SEAT BACK,ASSY,24"W,24"W-28"W,17"H,TRU-COMFORT 2,4 WAY STRETCHSET124631 SEAT BACK,ASSY,24"W,20"W-24"W,19"H,TRU-COMFORT 2,4 WAY STRETCHSET130062 SEAT BACK,ASSY,24"W,24"W-28"W,19"H,TRU-COMFORT 2,4 WAY STRETCHSET124633 SEAT BACK,ASSY,26"W,24"W-28"W,15"H,TRU-COMFORT 2,4 WAY STRETCHSET124634 SEAT BACK,ASSY,26"W,24"W-28"W,17"H,TRU-COMFORT 2,4 WAY STRETCHSET124642 SEAT BACK,ASSY,28"W,24"W-28"W,15"H,TRU-COMFORT 2,4 WAY STRETCHSET124646 SEAT BACK,ASSY,28"W,28"W-32"W,15"H,TRU-COMFORT 2,4 WAY STRETCHSET124647 SEAT BACK,ASSY,28"W,24"W-28"W,17"H,TRU-COMFORT 2,4 WAY STRETCHSET124648 SEAT BACK,ASSY,28"W,28"W-32"W,17"H,TRU-COMFORT 2,4 WAY STRETCH
ARMRESTS : TRU-Balance 3 Flip-Back ArmrestsTRU-Balance 3 Flip-Back, 8"-12"H, Left Standard ARM147810 ARMREST,ASSY,20"W-24"W,8''H-12''H,FULL LENGTH,VERSION 2,TRU-BALANCE 3,LEFT
TRU-Balance 3 Armrest Downpost No Charge MEC140975 DOWN POST,ASSY,8"H-11"H,STRAIGHT,LEFT,TRU-BALANCE 3MEC140977 DOWN POST,ASSY,12"H,STRAIGHT,LEFT,TRU-BALANCE 3MEC140979 DOWN POST,ASSY,13"H-14"H,STRAIGHT,LEFT,TRU-BALANCE 3MEC140981 DOWN POST,ASSY,15"H,STRAIGHT,LEFT,TRU-BALANCE 3MEC140983 DOWN POST,ASSY,16"H,STRAIGHT,LEFT,TRU-BALANCE 3MEC140976 DOWN POST,ASSY,8"H-11"H,STRAIGHT,RIGHT,TRU-BALANCE 3MEC140978 DOWN POST,ASSY,12"H,STRAIGHT,RIGHT,TRU-BALANCE 3MEC140980 DOWN POST,ASSY,13"H-14"H,STRAIGHT,RIGHT,TRU-BALANCE 3MEC140982 DOWN POST,ASSY,15"H,STRAIGHT,RIGHT,TRU-BALANCE 3MEC140984 DOWN POST,ASSY,16"H,STRAIGHT,RIGHT,TRU-BALANCE 3MEC140410 DOWN POST,ASSY,8"H-11"H,ENDOMORPH,LEFT,TRU-BALANCE 3MEC140416 DOWN POST,ASSY,12"H,ENDOMORPH,LEFT,TRU-BALANCE 3MEC140417 DOWN POST,ASSY,13"H-14"H,ENDOMORPH,LEFT,TRU-BALANCE 3MEC140418 DOWN POST,ASSY,15"H,ENDOMORPH,LEFT,TRU-BALANCE 3MEC140419 DOWN POST,ASSY,16"H,ENDOMORPH,LEFT,TRU-BALANCE 3MEC140990 DOWN POST,ASSY,8"H-11"H,ENDOMORPH,RIGHT,TRU-BALANCE 3MEC140991 DOWN POST,ASSY,12"H,ENDOMORPH,RIGHT,TRU-BALANCE 3MEC140992 DOWN POST,ASSY,13"H-14"H,ENDOMORPH,RIGHT,TRU-BALANCE 3MEC140993 DOWN POST,ASSY,15"H,ENDOMORPH,RIGHT,TRU-BALANCE 3MEC140994 DOWN POST,ASSY,16"H,ENDOMORPH,RIGHT,TRU-BALANCE 3MEC166424 DOWN POST,ASSY,8"H-11"H,MESOMORPH,LEFT,TRU-BALANCE 3MEC166429 DOWN POST,ASSY,12"H,MESOMORPH,LEFT,TRU-BALANCE 3MEC166430 DOWN POST,ASSY,13"H-14"H,MESOMORPH,LEFT,TRU-BALANCE 3MEC166431 DOWN POST,ASSY,15"H,MESOMORPH,LEFT,TRU-BALANCE 3MEC166432 DOWN POST,ASSY,16"H,MESOMORPH,LEFT,TRU-BALANCE 3MEC166433 DOWN POST,ASSY,8"H-11"H,MESOMORPH,RIGHT,TRU-BALANCE 3MEC166435 DOWN POST,ASSY,12"H,MESOMORPH,RIGHT,TRU-BALANCE 3MEC166436 DOWN POST,ASSY,13"H-14"H,MESOMORPH,RIGHT,TRU-BALANCE 3MEC166437 DOWN POST,ASSY,15"H,MESOMORPH,RIGHT,TRU-BALANCE 3MEC166438 DOWN POST,ASSY,16"H,MESOMORPH,RIGHT,TRU-BALANCE 3
ARMRESTS : Heavy Duty, Removable Armrests8"-12"H, Single Post, Height Adjustable, Removable, Heavy Duty $75 ea. ARM138631 ARMREST,ASSY,HD REMOVABLE,8"H-12"H,DESK LENGTH,TRU-BALANCE 3,LEFT,SHORT INSERT
Option Name MSRP Part Number Manufacturer Extended DescriptionSection Name
Q6 Edge HD Cross Reference Spreadsheet - TRU-Balance 3 Postioning
ARM134289 ARMPAD,ASSY,WATERFALL,FULL LENGTH LEFT/DESK LENGTH RIGHT COMBO,TUBE STYLE ARMREST
ARM134290 ARMPAD,ASSY,WATERFALL,DESK LENGTH RIGHT/STRAIGHT,DESK LENGTH LEFT COMBO,TUBE STYLE ARMREST
ARM134291 ARMPAD,ASSY,WATERFALL,DESK LENGTH LEFT/STRAIGHT,DESK LENGTH RIGHT COMBO,TUBE STYLE ARMREST
ARM134292 ARMPAD,ASSY,WATERFALL,DESK LENGTH RIGHT/STRAIGHT,FULL LENGTH LEFT COMBO,TUBE STYLE ARMREST
ARM134293 ARMPAD,ASSY,WATERFALL,DESK LENGTH LEFT/STRAIGHT,FULL LENGTH RIGHT COMBO,TUBE STYLE ARMREST
ARM134294 ARMPAD,ASSY,WATERFALL,FULL LENGTH RIGHT/STRAIGHT,FULL LENGTH LEFT COMBO,TUBE STYLE ARMREST
ARM134295 ARMPAD,ASSY,WATERFALL,FULL LENGTH LEFT/STRAIGHT,FULL LENGTH RIGHT COMBO,TUBE STYLE ARMREST
ARM134296 ARMPAD,ASSY,WATERFALL,FULL LENGTH RIGHT/STRAIGHT,DESK LENGTH LEFT COMBO,TUBE STYLE ARMREST
ARM134297 ARMPAD,ASSY,WATERFALL,FULL LENGTH LEFT/STRAIGHT,DESK LENGTH RIGHT COMBO,TUBE STYLE ARMREST
Single Actuator Control, Through Toggle (Power Tilt Only) No Charge ELE130021 ELECTRONIC,ASSY,Q-LOGIC/NE PLUS,THRU HIGH POWER TOGGLE,W/MANUAL RECLINE,TRU-BALANCE 3
ELE130022 ELECTRONIC,ASSY,REMOTE PLUS/Q-LOGIC//VSI/VR2/NE+/NE,THRU HIGH POWER TOGGLE,TRU-BALANCE 3
ELE1611928 ELECTRONIC,ASSY,REMOTE PLUS/Q-LOGIC//VSI/VR2/NE+/NE,THRU HIGH POWER TOGGLE,W/MANUAL RECLINE,TRU-BALANCE 3
POWER POSITIONING ELECTRONICSSingle Actuator Control, Through NE+ 6-Key Joystick $1,895 ELE130739 ELECTRONIC,ASSY,NE PLUS,INDEPENDENT LEGS,TRU-BALANCE 3 SEAT,(CONFIGURATION # 01)
POWER POSITIONING ELECTRONICS : Tilt Only through Toggle (Power Tilt Only)
Page 7 of 11
Option Name MSRP Part Number Manufacturer Extended DescriptionSection Name
Q6 Edge HD Cross Reference Spreadsheet - TRU-Balance 3 Postioning
ELE130008 ELECTRONIC,ASSY,NE PLUS,TRU-BALANCE 3 POWER TILT & RECLINE,TILT/RECLINE,(CONFIGURATION # 28)
Single Actuator Control through Q-Logic 3 Controller and Interface $1,895 ELE167826 ELECTRONIC,ASSY,Q-LOGIC 3/AM1,TRU-BALANCE 3 SEAT,POWER TILT,(CONFIGURATION # 20)