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J6 & J6 W/ PES
Order Form300 lbs. weight capacity
Revised: September 25, 2012 Page 1 o
Client Height:
Client Weight:A. Seat Width:
B. Lateral Offset:
C. Hip/Thigh Lateral Offset:
D. Center of Gravity: Optimized based on seat dimension
E. Seat Depth:
F. Back Height from Pan:
G. Lateral Height from Pan:
H. Armrest Height from Pan:
I. Rigging Length (whole numbers only):
J. Seat to Floor Height: qLow qMiddle qTall
Clinician Notes:
SPECIFIED DIMENSIONS*
While every effort will be taken to ensure items will be preset to your
pecications prior to shipping, variations in options may effect nal settings.
Please supply patient information for optimal setup prior to shipping.
Pride Mobility Products Corporation380 Vansickle Rd. St. Catharines, ON L2R 6P7
Phone: (888) 570-1113 Fax: (866) 514-1303
Date:
PO#:
Account Number:
Bill To:
Address:
Phone Contact:
Ship To:
Address:
Marked For:
Discount:
Terms:
Freight:
LOWEST SEAT-TO-FLOOR HEIGHTS
Contoured Seating 20.5”Specialty Seat 16.75”Synergy Seat 16.625”*(PES option adds approximately 1.5” to the lowest STF height listed.
Seating Lowest Seat-To-Floor
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J6 Order Fo
Revised: September 25, 2012 Page 2 o
All prices are MSRP.
BASE MODELDescription Price
qJ6 $4295
qJ6 w/ Power Elevating Seat Option 1 $5095
COLORqJazzy RedqJazzy Blue
DRIVE WHEELS
q10” Solid (pair) Stdq10” Pneumatic (pair) NC
BATTERY CHARGER
q 5 Amp Offboard Std
ELECTRONICS for non power elevating seat
q 75 Amp NE (not available w/ PES) Std
Description Price
JOYSTICK MOUNTING BRACKETS
FOOTNOTES. Only Available with VSI 6-Key Joystick. Includes 1/4 Speed Inhibit. Raises Seat-To-
Floor Height. NA with Synergy Manual Tilt or Recline.
. Includes black vinyl seatpan. Back available in listed colors.
. Call for conguration options with Shape Back
. Flip-up arms may interfere with swing-away laterals
5. Adjustable from 11" to 17" in .5" increments
. Not available with Waterfall Armpads
ELECTRONICS 1 for power elevating seat
q VSI 6-Key1 (required for PES) Std with PES
qBase Mounted Foot Platform StdqNo Base Mounted Front Platform NC
BASE MOUNTED FOOT PLATFORM
qFixed Inline StdqLeft qRight
qSwing-away $250qLeft qRightqInline qOffsetq4” Ext. q7” Ext.
qMulti-axis Fixed $200qLeft qRight(Fixed conguration. Does not swing away)
CONTOURED SEATING
MANUAL RECLINER
Armrests:qManual Recliner High Back with Headrest $6
qManual Recliner High Back with Headrest and Solid Seat Pan2 $6
Upholstery:
qBeige Vinyl qGray VinylSeat Width:
q16” $95 q18”Seat Depth:
q16” $95 q18”
SPECIALTY SEAT
Medium Back:qMed-Back Std
qMed-Back with Solid Seat Pan2 NC
High Back:qLimited Recline High-Back with Headrest $70
qLimited Recline High-Back with Headrest & Solid Seat Pan2 $70
Upholstery:
qBrown Vinyl qBeige Vinyl qGray Vinyl
qBlack Vinyl qGray Fabric qBrown Fabric
Seat Width:
q16” $95 q18” Std q20” $95
Seat Depth:
q16” $95 q18” $95 q20” Std
Seat Width:
q16” q18”
Seat Depth:
q16” q18”Upholstery:
qBrown Vinyl qBeige Vinyl qGray Vinyl
qBlack Vinyl qGray Fabric qBrown Fabric
Armrests:qFlip-Up, Removable Std
qFlip-Up, Height-Adjustable, Removable NC
Armpads:Left: qFull Length qDesk Length
Right: qFull Length qDesk Length
Depth Adjustable High Back:qLimited Recline Gray Vinyl Depth Adjustable $1
High Back w/ Headrest
q18”W x 18-20”D q20”W x 18-20”D
qSpecialty Seat Kit $3
Seat Width:
q16” q18” q20”Seat Depth:
q16” q17” q18” q19”
q20”Back Cane Height:
q18” q20” q22”
Armrests for Specialty Seating:q2-Post, Fixed Height, Flip Back3,4 NC
qFlip-Back, Cane Mounted3,4 $1
qRemovable, Quick Height Adjustable5 $1
qRemovable, Heavy Duty, Height Adjustable $1
q8-12” Adjustment range q10-14” Adjustment range
Armpads:Left: qFull Length qDesk LengthRight: qFull Length qDesk Length
Sling Back: $13
q16” W q18” W q20” W
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J6 Order Fo
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SYNERGY ® SEATING SYSTEMSDescription Price
eat Width:
q10” q11” q12” q13”
q14” q15” q16” q17”
q18” q19” q20”
eat Width Package:
q10”W-14”W q14”W-18”W q16”W-20”W
eat Depth:
q10” q11” q12” q13”
q14” q15” q16” q17”
q18” q19” q20”
eat Depth Package:
q10”D-14”D q14”D-18”D q16”D-20”D
Back Cane Height:
q14" q15" q16" q17"
q18” q19” q20” q21"
q22” q23” q24” q25”
BACK CANE OPTIONS
BACK OPTIONS
FOOTNOTES
1. N/A with Power Elevating Seat Option
2. Requires Solid Curved Back not included
3. Not available with Synergy Manual Recline, Synergy Manual Tilt, vent tray, baria
armpads, Tru-Comfort or sling back. May interfere with with lateral supports and
Waterfall Armpads.
4. Available with Tru Comfort seating only through SOF. Not available with SynergyManual Recline. Flip Back armrests may interfere with offset canes.
5. Interferes with swing-away laterals.
6. Adjustable from 11"-17" in 1/2" increments
7. Desk Length armrests with an accessory may interfere with access to headjustment lever. Adjustable Height from 7.75" to 9.75".
8. Height adjustment from 11-17" depends on cane height. Not available wManual Recline, Flip Forward back canes, Cane Clamp Pushbar, & ShapBack. Call for details when selecting aftermarket arm troughs or UniversSwivel.
9. TRU-ComfortTM Headrests are measured at the front of the headrest
qSynergy Seating Frame $995
qSynergy Manual Recline Package1,2 $625
qSynergy Manual Tilt Package1 $925Max. Seat Size 14”W x 14”D, 75 lbs Weight Capacity
qStandard Back Canes With Push Handles Std
qStandard Back Canes, No Push Handles $85
qFlip Forward Canes3 $150qOffset (Meso)4 $195
q2” (1” Per Side) q4” (2” Per Side)
qInset (Endo)4 $195
q2” (1” Per Side) q4” (2” Per Side)
qSynergy Back with 1.5” Thick Back Cushion $450
Back Height:
q18” q19”q20” q21”
q22” q23” q24” q25”
Lateral mounting rails:
q6” extension/height (For back heights 13”-16”H) $25
q10” extension/height (For back heights 17”-18”H) $25
q12” extension/height (For back heights of 19”H-22”H) $25
q16” extension/height (For back heights of 23”H-25”H) $25
qSynergy Shape Backs VariousSee Synergy Shape Back Order Forms For Detailed Pricing and Sizes
qSling Back $135
qOmit Backq TRU-Comfort™ Back 4-way Stretch Material Cover
A with Specialty Seat.
verall back height measured from top of seat pan to top of back +- 1/2”
Width: q 16”W q 18” W q 20”W $695Height: q 20” H q 21” H q 22”H q 23”H
q 24”H q 25”H q 27”H q 28”H
Width: q 17”W q 19”W $695Height: q 22”H q 23”H q 24”H q 25”H
q 27”H q 28”H
ru Comfort Colour Shroud Option:
q Black (Standard color option) NCq Colour Match Base $150
Description Price
ARMRESTS for Synergy seat only
qStraight, Full Length (2”x14”) StdqLeft qRightqStraight, Desk Length (2”x10”) NCqLeft qRightqWaterfall, Full Length (2”x14”) NC qLeft qRightqWaterfall, Desk Length (2”x14”) NC qLeft qRight
ARMPADS
qFlip-back, Cane Mounted5 Stdq2-post, Flip-back, Height-adjustable, Removable5 $138
(9”-13” of height adjustment in 1” increments)
qSingle-post, Height-adjustable, Removable6 $123qQuad Release Lever qRemovable, Single-post, Height Adjustable, Heavy Duty $123 q8”H - 12”H q10”H-14”HqPediatric, Removable7 $123ea Color: qMatch Shroud qBlack qQuad Release Lever
(7 3/4” - 9 3/4” height adjustment in 1/2” increments from seat pan to top of arm
qHeight-adjustable Cantilever Armrests (SOF) 8 $138 Angle-Adjustable: - 30 o through + 30 o
HEADRESTS
qNo Headrest Required
TRU-Comfort™ 9
q8”W TRU-Comfort Plus $325
q10”W TRU-Comfort Plus $325
qRemovable Headrest Bracket $180
Headrest measurement is taken from the inside of the headrest
POSITIONING COMPONENTS
q Stealth Thoracic Laterals (pair)Bracket:
q Swing-Away Rail Mount Bracket $50(For Use With Synergy Back and Tru Comfort Back)
Choose Pad:
q Flat Pad, 3” x 5” Leather-Like Cover $22 q Flat Pad, 4” x 6” Leather-Like Cover $22 q Curved Pad, 2” x 3” 4-Way Stretch Cover $22 q Curved Pad, 3” x 5” 4-Way Stretch Cover $22 q Curved Pad, 4” x 6” 4-Way Stretch Cover $22
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J6 Order Fo
Revised: September 25, 2012 Page 4 o
STANDARD LEGRESTS
FOOTNOTES
. Extensions are measured from top of seat pan to footplate
2. Standard with angle adjustable footplates with heel loops.
3. Available only with ELR's
4. Available only on seats 18"W or greater
5. Available only on seats 20"W
6. Available only on swing-away legrests.
7. Swing-away laterals interfere with ip back armrests.
8. Includes mounting hardware. Not available with Tru Balance Manual Recline or
Manual Recliner.
9. Not available with manual recline, includes mounting hardware. Tru Comfort Back
requires custom O2 holder, call for details.
0. Available with Synergy armrests only
q70o Swing-away Legrests1 $270
qStraight qTapered
q Standard Extruded Footplates StdExtensions Length:
q11”-13” q13”-16.5” q15.5”-19.5”Footplates Size:
q7.25” x 6” q8.5” x 6”
q Angle-Adjustable Footplates $165Extensions Length:
q11”-13”
q13”-16.5”
q15.5”-19.5”Footplates Size:
q4” x 6” q5” x 6” q5” x 8”
q6” x 8”4 q6” x 11”4 q8” x 11”5
q Multi-Axis Footplates $495Extensions Length:
q11”-16.5” q15.5”-19.5”Footplates Size:
q4” x 6” q5” x 6” q5” x 8”
q6” x 8”4 q6” x 11”4 q8” x 11”5
qHigh Mount, Clamp-On Footrestq Angle Adjustable $450
qSmall, 4” x 7.75” qLarge, 4.25” x 9.25”qMulti-Axis $465
qSmall, 4” x 7.75” qLarge, 4.25” x 9.25”
qHeavy Duty Drop-In Legrests
1,2
$420q Angle Adjustable Footplates Std
Extension Length:
q12”-14.5” q14.5” -18”Footplate Size:
q4” x 6” q5” x 6” q5” x 8”
q6” x 8”4 q6” x 11”4 q8” x 11”5
qElevating Legrests1 $520
q Standard FootplatesExtension Length:
q11”-14” q14”-17”Footplate Size:
q7.25” x 6” q8.5” x 6”
q Angle Adjustable Footplates $165
Extension Length:
q12”-14.5” q14.5” -18”
Footplate Size:
q4” x 6” q5” x 6” q5” x 8”
q6” x 8”4 q6” x 11”4 q8” x 11”5
q Calf Pad Adjustment3
q1 Hole q3 Hole q6 Hole
qPediatric Swing-Away Legrests1 $270
q Angle Adjustable Footplates $165Extension Length:
q7”-10”Footplate Size:
q4” x 6” q5” x 6”
Description Price
FRONT RIGGING ACCESSORIES
Description Price
HIGH MOUNT FOOT PLATFORM
qHigh Mount Foot Platform $45
q10”-14” Ext.1 q14”-17” Ext.1
qWheel Bumpers $2qHeel Loops (pair)2 $3qGel Neoprene Footrest Sleeve (pair)6 $1qELR/ALR Adductor Buttons (pair) $1qResidual Limb Support $2
qLeft qRight
(See Quantum accessories order form for additional options)
SYNERGY ® CUSHIONS
qNo Cushion RequiredPlease refer to Synergy order forms for detailed pricing and sizes.
Simplicity Cushion General Use
q16” x 16” - 20” x 20” $1Solution® 1 Cushion Skin Protection
q14” x 14” - 20” x 18” $2q20” x 20” $3Solution® Cushion Skin Protection & Positioning
q10” x 10” - 18” x 22” $3
q19” x 17” - 20” x 20” $4Solution® 1 LTC Cushion Skin Protection & Positioning
q14 x 16 - 20 x 20 $5Spectrum® Gel Cushion Positioning
q12” x 10” - 19” x 19” $5q20” x 16” - 20” x 20” $5Spectrum® Visco Cushion Skin Protection & Positioning
q10” x 10” - 19” x 19” $5q20” x 16” - 20” x 20” $5Spectrum Air Skin Protection q14” x 12” - 20” x 20” $5Spectrum Air Contour Skin Protection & Positioning q14” x 12” - 20” x 20” $6TRU-Comfort™ Seat Cushion General Use
q16” x 16” - 20” x 20” $3qPlus 4-way stretch material cover
ACCESSORIES
LAP BELTS
BATTERIES
qU-1, 32 Amp, Gel $180ea
qRear Basket8 $120
qCane/Crutch Holder 8 $120
qOxygen Holder Contoured Seating 8 $85
qOxygen Holder Synergy Seat 9 $85
qWalker Holder 8 $120
qFlag Holder $32
qStroller Handle Manual Tilt Only $85
qWeather Cover, Medium, Black $225
qCup Holder $32
qLeft qRight
qSaddle Bag $28q Tablet Holder 10 $395q Cell Phone/Media Holder 10 NC
q Deluxe Cell Phone/Media Holder 10 $175
q38” Lap Belt $24
q50” Lap Belt $24
q60” Lap Belt $24
q70” Lap Belt $24
q80” Lap Belt $24
q90” Lap Belt $24
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