Stimulite® Classic cushion — Order Form

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N° : FQ-113
Revision : 06
Stimulite® Classic cushion — Order Form
Date :
P.O.#:
Made for (client) Last name:
First name:
Ordered by :
Establishment :
CONFIRM ORDER BY E-MAIL
Yes 
No 
Address :
SUBSCRIBE TO PHYSIPRO NEWSLETTER
Yes 
No 
Phone :
YOUR EMAIL ADDRESS
Fax :
Stimulite® —Classic
Stimulite® —Classic XS
(to order the Classic XS please refer to the other side of this form)
Included: A laundry bag is provided with the purchase of each cushion
The Stimulite® Classic cushion, weighing 3 lbs (1.36 kg) and measuring 2½" thick, offers stability and support for
individuals suffering from a wide range of disabilities and whose weight does not exceed
Copyright 1998, Supracor inc. All
250 lb (113 kg) for 16" X 16" cushions and 325 lb (147 kg) for 17" wide and above cushions.
rights reserved .U.S. Patent
#5,701,621—#5,617,595
Machine washable and dryer safe, this cushion is available with a flat or sling bottom and can
#5,444,881—#5,180,619 and
other patents pending
Worldwide—Stimulite, Total
be ordered in non-standard sizes. *Take advantage of our 5% discount with the purchase
Pressure Management and
Supracor are registered
of 10 or more cushions.
Trademarks of Supracor, inc.
A) Classic — Standard sizes
Width
Depth
B) Flat

B) Sling
Code
Price

Code
Price
14"
16"
CL1416
$719.00
CL1416S
$750.00
16"
16"
CL1616
$719.00
CL1616S
$750.00
16"
18"
CL1618
$719.00
CL1618S
$750.00
18"
16"
CL1816
$719.00
CL1816S
$750.00
18"
18"
CL1818
$719.00
CL1818S
$750.00
18"
20"
CL1820
$750.00
CL1820S
$782.00
20"
16"
CL2016
$750.00
CL2016S
$782.00
20"
18"
CL2018
$750.00
CL2018S
$782.00
20"
20"
CL2020
$766.00
CL2020S
$797.00
$110.00
(CCL + size + S)
$110.00
Additional cushion cover Stimulite® Classic —Standard
Standard sizes
(CCL + size)
A) Classic — Non-standard sizes (please note that there are 2 non-standard options: 14" to 18" and 19" to 24")
Width
Depth
B) Flat

B) Sling

Code
Price
$844.00
CL0001S
$875.00
$860.00
CL0002S
$891.00
(CCL + size + S)
$110.00
Code
Price
CL0001
CL0002
Additional cushion cover Stimulite® Classic—non-standard (please indicate sizes)
(CCL + size)
$110.00
Physipro inc.
370, 10th South Ave., Sherbrooke (Quebec) J1G 2R7 / Phone : 819 823-2252 Toll-Free: 1-800 668-2252 / Fax: (819) 565-3337
Order: info@physipro.com
1
Stimulite® - Classic XS Cushion
Weighing 3 lbs (1.36 kg) and measuring 2½" thick, the Stimulite® Classic
Extra Sensitive cushion is specially designed for individuals with sensitive
skin. This cushion offers stability and support for individuals suffering from a
wide range of disabilities and whose weight does not exceed 225 lb (102 kg) for
16" X 16" cushions and 250 lb (113 kg) for 17" wide and above cushions.
Machine washable and dryer safe, the Classic Extra Sensitive cushion is available
with a flat or sling bottom and can be ordered in non-standard sizes.
*Take advantage of our 5% discount with the purchase of 10 cushions or
more.
A) Classic XS — Standard sizes
Width
Depth
B) Flat

B) Sling
Code
Price

Code
Price
14"
16"
CLXS1416
$766.00
CLXS1416S
$766.00
16"
16"
CLXS1616
$766.00
CLXS1616S
$766.00
16"
18"
CLXS1618
$766.00
CLXS1618S
$766.00
18"
16"
CLXS1816
$766.00
CLXS1816S
$766.00
18"
18"
CLXS1818
$766.00
CLXS1818S
$766.00
18"
20"
CLXS1820
$797.00
CLXS1820S
$829.00
20"
16"
CLXS2016
$797.00
CLXS2016S
$829.00
20"
18"
CLXS2018
$797.00
CLXS2018S
$829.00
20"
20"
CLXS2020
$844.00
CLXS2020S
$844.00
$110.00
(CCL + size + S)
$110.00
Additional cushion cover Stimulite® Classic XS—Standard
Standard sizes
(CCL + size)
B)
Width
A) Classic XS — Non-standard sizes
(please note that there are 2 non-standard options: 14" to 18" and 19" to 24" )
Depth
B) Flat

B) Sling
Code
Price
CLXS0001
CLXS0002

Code
Price
$891.00
CLXS0001S
$922.00
$938.00
CLXS0002S
$938.00
(CCL + size + S)
$110.00
Additional cushion cover Stimulite® Classic XS—non-standard (please indicate sizes)
(CCL + size)
$110.00
* Custom Special Cuts that require a drawing and are non-refundable *
For Custom Cuts Add $165,00
Shipping is not included in the price
Returned merchandizes are subject to a 20% restocking fee.
Prices are in Canadian dollars.
Prices and specifications are subject to change without notice.
Prices are effective from January 1, 2016.
E-Mail: order@physipro.com
Physipro inc.
370, 10th South Ave., Sherbrooke (Quebec) J1G 2R7 / Phone : 819 823-2252 Toll-Free: 1-800 668-2252 / Fax: (819) 565-3337
Order: info@physipro.com
Copyright 1998, Supracor inc. All
rights reserved .U.S. Patent
#5,701,621—#5,617,595
#5,444,881—#5,180,619 and
other patents pending
Worldwide—Stimulite, Total
Pressure Management and
Supracor are registered
Trademarks of Supracor, inc.
2