Order_form_q7

Quickie Q7 Adjustável
SUBMIT
Agosto 2015
EIR4
Nome do usuário:
Data
Informações Adicionais
Peso:
Altura:
Diagnóstico:
HCPCS
Option #
Definition
Price
Option #
HCPCS
Definition
Price
1. CONFIGURAÇÃO ESTRUTURA
Fechamento Frontal
See FIGURE 2 Frame Inset is the distance from the outside of the seat tube to
the outside of the footrest.
186FF1
0"
NC
186FF2
1" (NA w/ 12" wide)
NC
186FF3
2" (NA with 12" & 13" wide)
NC
Kit Performance

186QD01
Garfo Unilateral
Roda ultraleve
Pneu Schwalbe Marathon Plus
Evolution
Freio
Compacto
$
$
$
$
Estilo Estrutura
See FIGURE 3 Measurement for set up.
186FS9
Standard
186FS34
Classico

Kit Ultralite
Lona assento Ultralite
Roda ultraleve
Pneu Schwalbe Speed Run Tire
Freio Compacto
186QD02
* Standard – A estrutura é 4cm menor que a clássica Clássico – Tradicional
posicionamento utilizado para a distância entre o assento e a curva frontal.
A profundidade do assento não é alterada para ambos os modelos.
$
$
$
$
Posição da Roda Dianteira
See FIGURE 4
186LH01
Angulação Estrutura
See FIGURE 1 Measure from front frame to floor.
186FA1
75°
186FA8
80°

186FA2
85°
o
Figure 1

NC
NC
NC
Figure 2
NC
NC
186LH02
186LH03
Setting 1 Sugerida para rodas 3" & 4" .
Setting 2 Sugerida para rodas 5" & 6"
casters.
Setting 3 NA w/ 6" casters

Direct Mount (Opcional)
Apenas válido com freio compacto e cambagem de 0°..
Figure 3
Figure 4
Customer Service: 800-333-4000 Fax: 800-300-7502 Email: [email protected] www.sunrisemedical.com
Specifications are subject to change without notice. Copyright © 2011 Sunrise Medical (US) LLC. Q7, MK-100021 Rev F
Page 1
NC
NC
NC
1. CONFIGURAÇÃO ESTRUTURA
Figure 7
Encosto ajustável em profundidade (Opcional)
See Figure 5 Depth Adjust Backrest extends the frame rear of the seat sling,
select a factory setting.
186DP02
0 Setting Backrest at standard position,
field adjustable to -1" or -2"
$165.00
186DP03
-1 Setting Backrest -1" offset, field
adjustable to flush or -2"
$165.00
186DP04
-2 Setting Backrest -2" offset, field
adjustable to flush or -1"
$165.00
186OP01
Opções assento
Lona Standard
NC

186OP02
Lona Ultra fina Válido de 36-44cm
profundidade e larguar.
$

186OP04
Omit Seat Sling
NC

Largura do assento
See FIGURE 6 Measure from outside of seat tube to the outside of opposite seat tube.

186S3
186S4
186S5
186S6
186S7
30cm
33cm
36cm
38cm
40cm
NC
NC
NC
NC
NC
186S8
186S9
186S10
186S48
44cm
46cm
48cm
51cm
(E2201)
NC
NC
NC
$
Amofada Jay (Opcional)
To order any JAY cushions on-chair, please see the JAY price list.
Cushion name or part number must be filled out with desired width and depth
JAY Bundled Cushion
186JC20 Modelo:
$

Largura:
Profundidade:
Profundidade do assento
See FIGURE 7 Measure from front of back post to front edge of seat sling. Seat sling is 1"
shorter than depth ordered, but actual seat depth will remain the same as ordered.




186SD5
186SD6
186SD7
186SD8
186SD9
30cm
33cm
36cm
38cm
40cm
NC
NC
NC
NC
NC


186SD10
186SD11
186SD12

186SD13
44cm
46cm
48cm
51cm
(E2203)
NC
NC
NC
$
2. Altura Frontal
Altura frontal
See FIGURE 8 Measure from the front of the seat rail to the floor.
186SH14
40cm
186SH20
NC
186SH15
42cm
186SH21
NC


186SH16
43cm
186SH23
NC


186SH17
44cm
186SH24
NC


186SH18
46cm
186SH26
NC


186SH27

Figure 8
47cm
48cm
49cm
51cm
52cm
53cm
NC
NC
NC
NC
NC
NC


186CW1
186CW3
186CW31
186CW72
186CW44
186CW64
186CW5
186CW51
186CW6
186CW65
186CW7
186CW66
186CW34

186CW33

186CW35
186CW68

















186CF74
186CF65
186CF69
186CF53
186CF54
186CF55
Rodas Dianteiras
3" Micro
4" Low Profile Polyurethane
4" Micro Lighted
4" x 1" Aluminum Poly
4" x 1.25 Semi Pneumatic
4" x 1.5" Aluminum Soft Roll
5" Low Profile Polyurethane
5" Micro Lighted
5" Soft Roll (Grey) -NA w/Frog Legs
5" x 1" Aluminum Poly
5" x 1.5" Semi Pneumatic
5" x 1.5" Aluminum Soft Roll
6" Poly
E2214
6" Pneumatic
E2215
6" x 1.5" Semi Pneumatic
6" x 1.5" Aluminum Soft Roll
Garfos e Suspensões
Carbotecture Forks
Múltiplas posições
Múltiplas posições - unilateral
E1015 Frog Legs 0 até 45kg.
E1015 Frog Legs 46kg- 86kg
E1015 Frog Legs 87kg-120kg.
Customer Service: 800-333-4000 Fax: 800-300-7502 Email: [email protected] www.sunrisemedical.com
Specifications are subject to change without notice. Copyright © 2011 Sunrise Medical (US) LLC. Q7, MK-100021 Rev F
Page 2
NC
NC
$
$
$
$
NC
$
$
$
$
$
NC
$
$
$
NC
NC
$
$
$
$
3. Apoio de pés





186F229
186F274
186F276
186F51
Apoio dos pés
Alumínio Tubular
Alumínio Tubular com base
K0040 Ângulo Ajustável
K0040 Pedal Plataforma
186F111
K0040 Pedal Plataforma Ultralite
NC
$
$
$
$

186DI08


186DI03
186DI04
186DI05
186DI07
186DI02
186DI06




Adaptive Platform Spacer
NA with Aluminum Tubular or Ultra Lite Platform. Now available with
Angle Adj. Flip Back.
186AD1
Adaptive Platform 2" Spacer
186AD2
Adaptive Platform 4" Spacer
186AD3
Adaptive Platform 6" Spacer
Opcionais
High Mount Ext Tubes (NA w/ Tubular
K0037
footrest)
K0038 Faixa para perna
K0038 Faixa extra para perna
Capa em gel para hanger
Neoprene Impact Guards
Wear Pads
Position Plates (NA for Tubular Footrest)
$
$
$
$
$
$
$
$
$
$
4. Encosto
Choose Option 1 or 2

186B110

186B110


186B110
186B110
1. Encosto Altura Ajustável
25-36cm Altura
Setting
 25
 28
 31
30-40cm Altura
Setting
 31
 33
 36
36-46cm Altura
Setting
 36
 38
 40
40-51cm Altura
Setting
 40
 44
 46
NC
 33
 36
 38
 40
2. Encosto Fixo Ultralight
Select back height. 8", 9", or 10" only available with omit push handles. 17",
18", or 19" only available with fold down push handles
NC
186BB21
186BB20
186BB13
186BB14
186BB15
186BB16
NC
 44
 46
 48
 51
NC
186QT01
Standard
NC

186QT02
Low Profile
$

186PH6
Manoplas
Integral
NC

186PH5
Retrátil (dobrável)
$
186PH2
Omitir manoplas
NC




186BU1
186BU70
186BU71
186BU14
186BB17
186BB18
186BB19
186BB10
186BB11
186BB12
36
38
40
44
46
19"
Broches militares
Barra


8"
9"
10"
11"
12"
13"
Lona Encosto
Standard
E2611 Tensão Ajustável Nylon Balistico
E2611 Tensão Ajustável 3DX Vented
Omitir Lona
NC
$
$
NC
Only available on tension adjustable upholstery and Jay 3 Back
186VU1
US Marines Patch
186VU2
US Army Patch
186VU3
US Navy Patch
186VU4
US Air Force Patch
186VU12
Coast Guard Patch
186VU5
Purple Heart Patch
186VU8
Purple Heart with Marines Patch
186VU9
Purple Heart with Army Patch
186VU10
Purple Heart with Navy Patch
186VU11
Purple Heart with Air Force Patch
186VU13
Purple Heart with Coast Guard Patch
$
$
$
$
$
$
$
$
$
$
$
Telescoping Push Handlles have Double "D" tubing to eliminate rotation.
186OD5
NC
Narrow Backrest Inset
$
Encosto J3

J3 Back

186JB01
186A192
$

186A195
Manopla Telescópica - Baixa
Manopla Telescópica - Alta
Customer Service: 800-333-4000 Fax: 800-300-7502 Email: [email protected] www.sunrisemedical.com
Specifications are subject to change without notice. Copyright © 2011 Sunrise Medical (US) LLC. Q7, MK-100021 Rev F
Page 3
$
$
5. Configuração Traseira
Eixos Traseiros

Matrix altura Anterior x Posterior
30cm Profundidade
2.5" Max Front to Rear Seat Hgt.
33,36cm Profundidade
3.0" Max Front to Rear Seat Hgt.
38,40 cm Profundidade
3.5" Max Front to Rear Seat Hgt.
44,46 cm Profundidade
4.0" Max Front to Rear Seat Hgt.
48,51 cm Profundidade
4.5" Max Front to Rear Seat Hgt.
Altura Posteroir
33 – Somente com rodas
186RH11
traseiras de 20’’
34 – Somente com rodas
186RH12
traseiras de 20’’
186RH13
36 _ Com rodas tras. De 20’’
SOme
186RH14
37
- . Com rodas tras. De 20’’
Com
38 – Somente com rodas traseirasde
186RH15
20 e 22’’

186RH16

186RH17

186RH18







186RH19
186RH26
186RH20
186RH27
186RH21
186RH37
186RH22

186AX1
NC
NC
Centro de Gravidade Ajustável (1"-4")
Cenrto de Gravidade Ajustável (0"-3")
Suspensão Traseira (Opcional)
186SV08
186SV09
$
$
Weight from 0 lbs to 175 lbs
Weight from 176 lbs. to 265 lbs


Rear seat height is 16.5" to 20", 0° camber, ships with 1" COG, pneumatic tire. 24" wheels
only. Anti-Tips no charge. NA w/ Padded Swing Arms or Transit.



Please select one of the following handrim options
186XH3
Plastic Coated
186XH4
Stainless Steel


186XA1
186XA7

186XA2

186XA4
NC
NC
Xtender – Outras Opções
Spare NiMH Power Pack - NICKEL
Spare NiMH Power Pack - LITHIUM
Xtender Opções de Rodas
E2211
SPARE 24" Lite Spoke Pneu Alum
E2212
E2211
SPARE 24" Lite Spoke Pneu Plastic
E2213
$
$
NC
$
Posicionamento do Centro de gravidade
Measure from front of back post to the center of rear axle.
0
186CC12
1cm
186CC1
2,5cm
186CC2
4cm
186CC3
5 cm
186CC4
6cm
186CC5
8cm
186CC6
9cm
186CC7
10cm
186CC8
NC
NC
NC
NC
NC
NC
NC
NC
NC
Cambagem


186CI1
186CI2

186CI4
0°
3°
6º
Wheel 5 Spoke
Mag
Tire
Mag
20,22,24 20,22,24
Full Poly Tire
High Press. Clincher
20,22,24
24
SHOX Perform. Poly
Knobby V-TRAK
20,22,24 20,22,24
Pneumatic
Pneumatic
20,22,24 20,22,24
w/Airless Insert
Schwalbe Marathon
Schwalbe Speed Run
22" = 489 mm 24" = 540 mm
NC
NC
NC
Lite Spoke
Ultra
Lt wt
Spinergy
22,24,25
22,24,25,26
20,22,24
22,24,25,26
24,25
24,25
24
24
20,22,24,26
22,24,26
20,22,24,26
22,24,26
24,25,26
22,24,25
24,25,26
24,25
24,25
24,25
25" = 559 26" = 590

186AX13
39 - Somente com rodas traseirasde
20 e 22’’
40
ND com rodas 24, 25 & 26"
41
ND com rodas 24, 25 & 26"
44
45
46
47
48
49
51
ND com suspensão
Axle
Eixo de liberaão rápida
Eixo de liberação rápida nas 4 rodas
NC
NC
NC
NC
NC
NC
NC
NC
NC
NC
NC
NC
NC
NC
NC
NC
$
Rodas Traseiras
Ultra Lightweight apenas disponível com aro de propulsão em alumínio

















186RW3
186RW8
186RW1
186RW103
186RW104
186RW102
186RW90
186RW91
186RW92
186RW93
186RW94
186RW06
186RW10
186RW16
186RW28
186RW95
186RW96
186RW97
186RW32
186RW98
186RW99
186RW40
186RW50
20" Mag
22" Mag
24" Mag
20" Mag Wheel 5 Spoke
22" Mag Wheel 5 Spoke
24" Mag Wheel 5 Spoke
20" Lite Spoke
22" Lite Spoke
24" Lite Spoke
25" Lite Spoke
26" Lite Spoke
22" Ultra Lightweight Spoke 2.0
24" Ultra Lightweight Spoke 2.0
25" Ultra Lightweight Spoke 2.0
22" Spinergy SPOX Black Spokes
24" Spinergy SPOX Black Spokes
25" Spinergy SPOX Black Spokes
26" Spinergy SPOX Black Spokes
22" Spinergy LX Black Spokes
24" Spinergy LX Black Spokes
25" Spinergy LX Black Spokes
26" Spinergy LX Black Spokes
24" Mountain
Customer Service: 800-333-4000 Fax: 800-300-7502 Email: [email protected] www.sunrisemedical.com
Specifications are subject to change without notice. Copyright © 2011 Sunrise Medical (US) LLC. Q7, MK-100021 Rev F
Page 4
NC
NC
NC
NC
NC
NC
$
$
NC
NC
$
$
$
$
$
$
$
$
$
$
$
$
$
5. CONFIGURAÇÃO TRASEIRA

186RT3

186RT6

186RT38


186RT27
186RT12
186RT1

186RT2

186RT21

186RT28
E2218
E2211
E2212
E2218
E2211
E2212
E2211
E2212
E2211
E2212
E2211
E2213
E2211
E2212
E2211
E2212
Aro de Propulsão
Pneu Traseiro
Full Poly Tire
NC
High-Pressure Clincher
$
SHOX Performance Poly
$
Knobby V-TRAK by Kenda
$
Mountain Only available in 24"
$
Pneumatic
NC
Pneumatic Airless Insert
$
Schwalbe Marathon Plus Evolution
$
Schwalbe Speed Run Tire
$
Natural Fit Handrims compatível com rodas 22", 24", & 25".
186HR1






186HR4
186HR22
186HR23
186HR30
186HR31
186HR24
186HR7
Aluminum Anodized
Plastic Coated
ND c/ rodas 25"
& 26" Lite Spoke
Natural Fit - Standard Grip
Natural Fit - Super Grip
Natural Fit LT - Standard Grip
Natural Fit LT - Super Grip
Spinergy Flex Rim Apenas
disponivel c/ Spinergy LX 24" & 25"
Omit Handrim
ND c/ rodas Ultra Lightweight
NC
$
$
$
$
$
$
NC

5. APOIO DE BRAÇOS
Apoio de braço acolchoado- Swing Away
Please select a setting, will default to 11" if no selection is made
186AA18
Setting
E0973 Acolchoado Swing-Away STD
 23
 25
 28
 30


186AA11
E0973

186AA29
E0973
33


186AM23
186AM21
186AM24
186AM22

186NP01



Some limitations when used with the Angle Adjustable Back in the rear most setting
$
36
Apoio de braço – altura ajustável
Single Post Height Adjustable – Ajuste
de 20 -33cm altura
Single Post Height Adjustable - Low
Ajuste de 16- 26,5cm altura
$
Armpad para Apoio altura ajustável
Desk Length (25cm) Classic
Desk Length (25cm) Contour
Full Length (36cm) Classic
Full Length (36cm) Contour
NC
NC
NC
NC
Opcionais
Pad de gel para apoio swing - away
$
$
6. ACESSÓRIOS
Freios
Protetor de roupas - Cor
Not all wheel locks available in all seat depths, wheel size, or COG
186WL1
Freio alto acion. Para frente
186WL2
Freio alto acion. Para trás

186WL45
Ergo Scissor

186WL30
Compacto

186WL10
Omit Wheel Lock

NC
NC
NC
$
NC
Available with Aluminum or Aluminum with Fender.
186GE01
Preto
186GE02
Mesma cor da cadeira – cores padrão

186GE03
Mesma cor da cadeira – cor customiz.




186A117
186A118
186A141
Extensor de freio
186EH7

186AT37
E0961 Extension Handle (Pair)
$65.00
Anti-tombos
E0971 Anti Tips (Pair)

186SG29

186SG35

186SG36
186SG12
Plástico Standard
ND com apoio de braço Ang Adjs
K0108 Plastico Low ND com apoio de braço
Ang Adjs ND com apoio de braço
Aluminio
K0108
Ang Adjs, freio alto
K0108
K0108 Alumínio com fenda, ND com apoio
de braço Ang Adjs e freio alto
Fibra de carbon, ND com apoio de
K0108
braço Ang Adjs e freio alto
Not available with 5 spoke MAG wheels
186A23
K0065 Preto
186A302
K0065 Quickie "Q" Clear

$


Protetor de Roupas
186SG33
Cintos de posicionamento
E0978 Belt 2" Aircraft Buckle w/clamps
E0978 Belt 2" Aircraft Buckle Padded w/clamps
E0978 Belt 1.5" Auto Buckle Universal w/clamps
$
$
$
Protetor de Rodas
Ext. handles only available with high mount push or pull wheel locks

NC
NC
$
$
$



186A1
186A2
186A8
186A203
186A83
Acessórios
Mochila adulto
Mochila infantil
Black Seat Pouch
E2207 Suporte muletas
Kit ferramentas
$
$
$
Customer Service: 800-333-4000 Fax: 800-300-7502 Email: [email protected] www.sunrisemedical.com
Specifications are subject to change without notice. Copyright © 2011 Sunrise Medical (US) LLC. Q7, MK-100021 Rev F
Page 5
$
$
$
$
$45.00
$
$
6. ACESSÓRIOS
186C118
186C140
186C2
186C141
186C10
186C38
186C36
186C14
186C35
186C142
186C143
186C126
186C144
186C147
186C148
186C103
186C114
186C145
186C113
186C8
186C44
Cor da Estrutura
Bead Blast
Aztec Gold
Black (Not avail as base w/Zebra)
Black Cherry
Black Opal
Blue Opal
Candy Blue
Candy Purple
Candy Red
Electric Blue
Evergreen
Glow
Green Apple
Hot Sparkle Pink
Mauve Pink
Rootbeer
Sparkle Silver
Sunrise Orange
Titanium Color Paint
Yellow
Glossy White - Limited Edition

186C116
186C151
Cores Foscas
Matte Black
Matte Black Cherry

186C150
Matte Electric Blue
NC
NC
NC

186C149
Matte Evergreen
NC
One Arm Drive

186C152
Matte Purple
NC
Unilateral Wheel Locks





















NC
NC
NC
NC
NC
NC
NC
NC
NC
NC
NC
NC
NC
NC
NC
NC
NC
NC
NC
NC
NC



186C112
186C43
186C42

186C108
Cores customizadas
Desert Camouflage
Mossy Oak Camouflage
Stars & Stripes
Zebra (Choose above base color) Std with
White unless above base paint is chosen
NA w/ Black
$
$
$
$
Peças anodizadas
Garfos, Suporte do Encosto e abraçadeira do suporte de roda
186EB07
186EB08
186EB09
186EB10
186EB11
186EB12
Preto
Azul
Verde
Roxo
Vermelho
Cinza Titanio
Built For Me
To inquire about any unique customization for Quickie products, contact:
Phone: (800) 333 - 4000, Option #3, Fax: (800) 333 9011
Commonly Requested Options Include:
Swing Away Knee Adductors
Seat Pan
Caster Pin Lock
Grade Aids
Spinergy Color Spokes
Double D Telescoping Push Handles
Customer Service: 800-333-4000 Fax: 800-300-7502 Email: [email protected] www.sunrisemedical.com
Specifications are subject to change without notice. Copyright © 2011 Sunrise Medical (US) LLC. Q7, MK-100021 Rev F
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