Alternative Drive Control Order Form
Transcription
Alternative Drive Control Order Form
PO#: Type: Customer: Contact: Date: E-mail: 104 John Kelly Drive, Burnet, Texas 78611 • tel: 1.800.965.9229 • fax: 1.800.806.1225 • email: info@stealthproducts.com Alternative Drive Control Order Form Chair Manufacturer Chair Model Tri-Array Series i-Drive Head Control System E2330 Pro Series i-Drive Head Control System E2330 IDH200-1 Adult Tri-Array System $4,175.00 IDH300-1 Adult Pro System $4,220.00 IDH250-1 Pediatric Tri-Array System $4,175.00 IDH350-1 Pediatric Pro System $4,220.00 Combo style Tri-Pad Headrest (E0955) IDH500-1 i-Drive Head Control Interface, nonproportional proximity switch mechanism, with egg switch* for reset mode change (E2330) Package Includes Occipital Pad (E0955) SUS9-B-HW Bilateral Swing-Away Hardware (E1028) IDH500-1 i-Drive Head Control Interface, nonproportional proximity switch mechanism, with egg switch** for reset mode change (E2330) * SUS9 Swing-Away required to mount switch to headrest ** Figure 8 Bracket required to mount switch to headrest Package Includes 2 Spot Pads - Choose Size: Refer to page 3 for mounting hardware selection Call Stealth Products for addition support and advanced configurations. IDH520 910 Invacare Power Interface (Required for use w/ Invacare MKVI Electronics) IDHM-CE-I Cervical Extension Inhibit Switch * No Charge when ordered with an i-Drive system. 3" x 2" 900 4.5" x 2" $180.00* $75.00 Reset Egg Switch Color Standard Egg Switch Color is Black. ES-BLU Blue ES-BLK Black ES-GRN Green ES-RED Red ES-YEL Yellow Swing-Aways SUS9-L-HW Left Side Swing-Away (E1028)** $275.00 SUS9-B-HW Bilateral Swing-Away (E1028)** $310.00 L R $250.00 F8675 Figure 8 Bracket (K0108)† SUS9-R-HW Right Side Swing-Away (E1028)** $275.00 ** The SUS9 is included and not available for mounting additional switches or pads on the Ultra Pro only (IDH300-1) † Figure 8 Bracket required for mounting additional switches and pads on the Ultra Pro or Tri-Array w/ swing away hardware. KN1ADD Knee Add. Swing-Away (K0108) Reset Egg Switch Mounting None SUS9 On Swing-Away Hardware‡ L ARMS260 R Select Cane Mount Size F8675 L R ESRM Swing-Away Armrest Mount (E1028) $250.00 ‡ SUS9 Swing-Away or F8675 Figure 8 Must be ordered for this option. Additional Proximity Switches IDH501 Proximity Sensor Select pad to cover switch IDH502 SUS9 L No Pad R F8675 L K0108 $525.00 R 900 4.5x2" $448.00 F8675 Embedded MC Switch No Pad 900 4.5x2" MC210 Tash Mini Cup Switch Mark for: DOC-240414; Rev 6 L 910 3x2" R L R 920 6x2" L R L $195.00 930 6x1.5" R $49.00 KN1ADD-TRK Knee Add. Swing-Away w/ Track Mount (K0108) IDH503 Fiber Optic Select Mount for Fiber Optic L $235.00 R FO660 FO660 Swing-Away Mount L R FO650 FO650 Pad Mount $625.00 FO690 $125.00 FO690 Tray Mount SUS9 K0108 $75.00 MC220 13/8" Finger Egg Switch Mount (K0108) ‡ Beam Sensor mounts to the back of the occipital pad. IDHA-D-1 Dongle Cable 1" Cane 910 3x2" Beam Sensor‡ Additional Mechanical Switches SUS9 $215.00 11/4" Egg Switch ES-BLK L ES-BLU ES-GRN R F8675 L R ES-RED $77.00 ES-YEL ML210 Tash Micro-Lite Switch L R L R $150.00 SP625 L R L R $325.00 Sip & Puff for Swing Away PO#: July 21, 2014 Tray-Array Series i-Drive Control System IDT100-1 Proximity Sensor Tray Array* $5,200.00 Package Includes GAT440 Hollow Eclipse Tray (K0108), IDH500-1 i-Drive Control Interface, GAT419 360 degree Tray Mount, 4 nonproportional proximity switch mechanisms, with egg switch for reset mode change (E2330) IDTF100-1 Tray Array - 3 Fiber Optic Sensor* $4,350.00 IDTF100-2 Tray Array - 4 Fiber Optic Sensor* $4,650.00 Package Includes Package Includes GAT440 Hollow Eclipse Tray (K0108)IDH500-1 iDrive Control Interface, GAT419 360 degree Tray Mount, 3 fiber optic proximity switch mechanisms, with egg switch for reset mode change (E2330) GAT440 Hollow Eclipse Tray (K0108)IDH500-1 iDrive Control Interface, GAT419 360 degree Tray Mount, 4 fiber optic proximity switch mechanisms, with egg switch for reset mode change (E2330) * Refer to page 4 to select Gatlin midline mounting system for trays. Sip & Puff Series i-Drive Control system IDH210-1 Adult Tri-Array w/ Sip & Puff $4,550.00 IDH310-1 Adult Pro Series Array w/ Sip & Puff Package Includes Combo style Tri-Pad Headrest (E0955) IDH500-1 i-Drive Head Control Interface, 2 non-proportional proximity switch mechanism, sip & puff straw, swing-away tube mount, with egg switch for reset mode change (E2330) 910 Refer to page 3 for mounting hardware selection for head arrays. Sip & Puff Series Accessories SP625-S12 Replacement Straws - Set of 12 SP625-S Replacement Straw for Sip & Puff $4,495.00 Package Includes Occipital Pad (E0955) SUS9-B-HW Bilateral Swing-Away Hardware (E1028) IDH500-1 i-Drive Head Control Interface, 2 non-proportional proximity switch mechanisms, sip & puff straw, F8675 figure 8 tube mount, with egg switch for reset mode change (E2330) 2 Spot Pads - Choose Size: 3" x 2" 900 4.5" x 2" $30.00 SP625-CT Clear Tubing for Sip & Puff $95.00 $12.50 SP625-F Replacement Sip & Puff Filter $15.00 i-Connect for Manual Bases (12V) i-Connect for Power Bases (24V) Proximity Sensor** Proximity Sensor† IC12P-1 Proximity 12V w/ Single Mono Plug** $585.00 IC24P-1 Proximity 24V w/ Single Mono Plug† $585.00 IC12P-2 Proximity 12V w/ Dual Mono Plug** $965.00 IC24P-2 Proximity 24V w/ Dual Mono Plug† $965.00 Fiber Optic Sensor** Fiber Optic Sensor† IC12F-1 Fiber Optic 12V w/ Single Mono Plug** $675.00 ** Requires 12V Power Source IC24F-1 Fiber Optic 24V w/ Single Mono Plug† † Requires 24V Power Source Sip & Puff‡ Sip & Puff‡ ICSNP-2 Sip & Puff w/ Dual Mono Plug‡ ‡ Does NOT Require a Power Source $475.00 i-Connect Power Source (12V) ICSNP-2 Sip & Puff w/ Dual Mono Plug‡ ‡ Does NOT Require a Power Source $475.00 i-Connect Power Source (24V) IC12A-BC 12V Battery & Charger for i-Connect $295.00 IC12A-W 12V AC Wall Adapter for i-Connect $65.00 IC24PS-MK6I Power Source for Invacare MKVI $280.00 IC24PS-QL Power Source for Q-Logic Electronics $280.00 IC24PS-RN Power Source for R-Net Electronics Notes: Mark for: $675.00 PO#: $280.00 Precision Mini Proportional Joystick IDPMP-1 Precision Mini Proportional Joystick $3,075.00 Please select a top and mounting option when ordering a joystick Please Select Joystick Handle Option Grip Cone Tip Mounting Options SM670 Stealth PMPJ Mount for Swing-Away Hardware $250.00 GAT486 Stealth PMPJ Mount for Gatlin $125.00 GAT487 Button Stealth PMPJ Mount for Gatlin (360°) $175.00 GAT441-PMP 4" x 6" Tray w/ Stealth PMPJ Mount $375.00 IDHA-ECU4 9-Pin Cable w/ 4 Mono Plugs $135.00 Environment Control Unit IDHA-ECU3 9-Pin Cable w/ 3 Mono Plugs Head Positioning & Headrest Hardware $125.00 E1028 Mounting Hardware A TWB480-17mm Link Style Hardware $220.00 B TWB485-17mm Link Hardware with Offset Square Tubing $210.00 C TWB480-17FDM Link Style Hardware with Flip Down K0108 Hardware Parts & Replacements FDM350 HMO Series Flip Down Mount Sub-Occipital Pad $150.00 A B C $299.00 TWB-LINK 3" (Long) Link w/ Set Screw $50.00 Sub-Occipital Pads K0108 To attach a sub-occipital pad it is required to include the SU980 and ultra mounting hardware. SU980 Ultra QCRS Adapter K0108 $275.00 600 Ultra 8" x 2.75" Medium Sub-Occipital Pad $50.00 620 Ultra 10.5" x 2.75" Large Sub-Occipital Pad $50.00 i2i Sub-Occipital Pads Low Profile i2i for Sub-Occipital Pad S M L Stealth Ultra Mounting Hardware TWB480-QCRS Link Style Hrdw $220.00 TWB485-QCR $210.00 w/ Square Tubing TWB480-QFDM Link Hrdw w/ FDM $299.00 i2i Modifications Gel Modification Adjustable Arms Notes: Mark for: $325.00 XL PO#: $169.00 $20.00 Chin Prompt $75.00 Trachea Chin Prompt $100.00 Peripheral Mounts Gatlin Midline Mount 8 Position GAT400Q 3/4" Gatlin 8 Position Armrest Mount for Quantum or Quickie GAT400I 3/4" Gatlin 8 Position Armrest Mount for Invacare GAT400P 5/8" Gatlin 8 Position Armrest Mount for Permobil Invacare Electronic Mounts GAT425I Invacare Mark IV Joystick Mount GAT426I Invacare Mark V Joystick Mount $575.00 ea. $575.00 ea. $575.00 ea. $125.00 ea. 3 Position GAT405Q 3/4" Gatlin 3 Position Armrest Mount for Quantum or Quickie GAT405I 3/4" Gatlin 3 Position Armrest Mount for Invacare GAT405P 5/8" Gatlin 3 Position Armrest Mount for Permobil Quantum Electronic Mounts GAT452Q Curtis Stand Alone Joystick Mount $575.00 ea. $575.00 ea. $575.00 ea. $175.00 ea. $125.00 ea. GAT453Q Stand Alone Joystick Mount (w/ 360°) $125.00 ea. GAT427I Invacare Mark VI MPJ Mount $125.00 ea. GAT456Q Q-Logic Joystick Mount $125.00 ea. GAT455S SPJ, DPJ, Mk IV-VI Mount (w/ 360°) $125.00 ea. GAT457Q Q-Logic Joystick Mount (w/ 360°) $175.00 ea. GAT480R Invacare 1812 Joystick Mount $125.00 ea. GAT473Q Quantum HMC-Compact Joystick Mount$125.00 ea. GAT428I Invacare Mark VI MPJ Mount (w/ 360°) $125.00 ea. GAT495QL Q-Logic Display Swivel Mount (w/ 360°) $175.00 ea. GAT429I Invacare Mark VI PSF Mount (w/ 360°) $195.00 ea. GAT495I Invacare Display Mount (w/ 360°) $220.00 ea. Permobil Electronic Mounts GAT435-RN Permobil R-Net Joystick Mount $125.00 ea. GAT496I Invacare Mk VI Display Mount (w/ 360°) $220.00 ea. GAT458P Permobil Omni Light Mount (w/ 360°) $195.00 ea. GAT483 ASL MEC Joystick Mount $125.00 ea. GAT459P Compact HMC-RN Mount (w/ 360°) $195.00 ea. GAT491 Mini ASL Joystick Mount $125.00 ea. GAT472P Permobil Omni Light Mount $125.00 ea. GAT473P Permobil Compact HMC-RN Mount $125.00 ea. Gatlin Trays/Accessories GAT440 Hollow Partial Exlipse Tray (w/ 360°) $150.00 ea. GAT441S Solid Mini Tray (w/ 360°) $225.00 ea. GAT440S Solid Partial Eclipse Tray (w/ 360°) $200.00 ea. GAT441-IP Tablet Mount (w/ 360°) $375.00 ea. GAT441 Hollow Mini Tray (w/ 360°) $375.00 ea. GAT-ESM Gatlin Egg Switch Mount $125.00 ea. GAT440M-L Solid Partial Eclipse Tray w/ Mini Joystick Mount - Left Side (w/ 360°) $475.00 ea. GAT440M-R Solid Partial Eclipse Tray w/ Mini Joystick Mount - Right Side (w/ 360°) $475.00 ea. GAT441AM Solid Mini Tray w/ ASL Joystick Mount (w/ 360°) $375.00 ea. ARMS260 Swing-Away Hardware ARMS260-UNI Cellular Device Swing-Away Mount $250.00 ea. ARMS260 Swing-Away w/ Egg Switch Mount $250.00 ea. ARMS260-TAB Small Tablet Swing-Away Mount ARMS260-I Invacare Mk VI Display S/A Mount $250.00 ea. ARMS260-MPJ Invacare MPJ Swing-Away Mount $275.00 ea. ARMS260-QL Q-Logic Display S/A Mount $250.00 ea. ARMS260-MEC ASL MEC Joystick S/A Mount $275.00 ea. ARMS260-P Omni Plus Display S/A Mount $250.00 ea. TWBM260-RNETVD R-Net Joystick S/A Mount $325.00 ea. $250.00 ea. TWBM480-TAB Tablet Mount $450.00 ea. $250.00 ea. TWBM480-DS $250.00 ea. $400.00 ea. TWBM480 Link Hardware TWBM480-QL Q-Logic Display Mount TWBM480-SPJ Invacare Mk VI SPJ Mount Invacare SPJ, DPJ, Mk IV Mount Mounts for Peripheral Mounts ARM250-S Height Adjustable Cane Mount for 3/4" Mounts $125.00 ea. ARM250-P Height Adjustable Flat Mount w/ Track Nuts for Permobil 5/8"Mounts $125.00 ea. ARM250-PC Height Adjustable Cane Mount for Permobil 5/8" Mounts $125.00 ea. ARM250-Q Height Adjustable Cane Mount for Quantum or Quickie 3/4" Mounts $125.00 ea. ARM250-I Height Adjustable Cane Mount for Invacare 7/8"Mounts $125.00 ea. ARM250-3/4"FM Height Adjustable Mount w/ Flat Bracket for 3/4" Mounts $125.00 ea. ARM240-I Non-Adjustable Cane Mount for Invacare 7/8" Mounts $75.00 ea. ARM240-T Non-Adjustable Track Mount w/ Track Nuts for 3/4" Mounts $75.00 ea. Mark for: PO#:
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