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: [email protected]
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#: