TA Power Wheelchair Request for Quote

Client Name(Required)

User Weight(Required)

Therapist(Required)

Date(Required)

Email Address(Required)

Phone Number(Required)

Organisation(Required)

Funded by(Required)

Enable ACC

Enable MOH

Accessible MOH

Private

Standard Specifications * - No Up-Charge

Standard Specifications

Power functions: tilt, elevate

Manual back recline 50 degrees Turning radius 18”/45cm

Base width 22”/56cm / chair length w/o footrest 27”/69cm

10” Front wheels

Super low floor to seatpan 12”/38cm with power elevate

RNET expandable electronics

2 Pole, 450w motors, Range max 22km

Controller Swingaway RH or LH

The client can remain seated in the power wheelchair during vehicle transport. Safety crash tested design. ISO7179-19, NZ LVVTA 45-60 2.6.

Type of Wheelchair

Mid Wheel Drive

Front Wheel Drive

Rear Wheel Drive

Indoor

Seat Width & Depth

Seat Width

10”/25.4cm (Junior)

12”/30.5cm (Junior)

14”/35.6cm (Junior)

16”/40.6cm

18”/45.7cm

20”/50.8cm

21.5”/54.6cm

Other

Seat Depth

10”/25.4cm

12”/30.5cm

14”/35.6cm

16”/40.6cm

18”/45.7cm

20”/50.8cm

21.5”/54.6cm

Other

Power Functions - Base

At No Charge

Tilt

Elevate

Optional Power Functions

Back recline

Power centre

Floor to seat pan

Floor to Seat Plan Options

15-16.75” *Standard

17-17.75”

18-18.75”

19-19.75”

Other

*With TA power elevate functions

Maximum Overall Width

22”/56cm Standard

Lower Leg Support Assembly

Manual

Manual - Centre

Manual - 70° swing away - stepless L/H

Manual - 70° swing away - stepless R/H

Power Centre

Power Centre - standard (13”-18.5”)

Power Centre - short (10”-13.5”)

Power Centre - short (pivots under seat)

Power Elevating - L/H

Power Elevating - R/H

TA Junior

Manual - Centre

Footplate

Manual centre - standard

Manual centre - with pull up system

Manual centre - wider with extended lip

Divided left & right (pair)

Electric flip-up

Posterior foot support (heel loops)

Junior Footplate

Manual - Centre Standard

Controller Electrics

RNET is standard

Controller Electrics Options

PG JSM LED w/o display (no lights) (standard on Indoor + Junior)

PG JSM2 Large colour screen (can be used on chair fitted with LED lights)

PG JSM2 Bluetooth Large colour screen

PG JSM LED with lights (for chair fitted with LED lights)

PG JSM Colour screen with lights (for chair fitted with LED lights)

Attendant control dual - Standard

Attendant control carer handle

Head array

Leg Support

Leg Support Options

Drop in seat guides

Thing Guides - Sml (7.5x10cm)

Thigh guides - Med (10x13cm)

Thigh guides - Lrg (13x15cm)

Back Configuration

Back Configuration Options

No upholstery

Tall straight 1” - adjustable width (also for Junior)

Contour design - adjustable width

Contour design - adjustable width - Junior

Controller Swing-Away / Dropdown

Controller Swing-Away / Dropdown Options

Right hand side swingaway

Left hand side swingaway

Swing-away

Stump Support

Stump Support Options

Left

Right

Both

Arm Support

Arm Support Options

Desk

Full length

Flip-up

Dual post flip-up

Adult

Paediatric

Standard leather

Get

Gutter

Pelvic Positioning Belt

Pelvic Positioning Belt Options

Standard

Small

2 point padded

4 point padded

Medium / Large

Tyres

Drive Tyres

Pneumatic (standard)

Solid

Seating Cushion

Please specify size (width x height):

Cushion Options

Please specify cushion:

Covers:

Inco

Confair

Covers are available for Vicair Adjuster, Vicair Vector and Nxt Biofit.

Seating - Back System

Options

Not required

Nxt Xtend Active (AC)

Nxt Xtend Deep (PC)

Nxt Optima Carbon Active (AC)

Nxt Optima Carbon Deep (PC)

Other

Please specify size (width x height):

Headrest

Headrest options

Not required

TA standard headrest (leather)

Nxt Multi Fit - Contoured

Nxt Multi Fit - Large

Nxt Multi Fit - Extra Large

TA Junior 5"

TA Junior 7"

Other

Please specify headrest required:

Setup Instructions

Accessories (view accessories catalogue on our website)

CAPTCHA

Online Quote Form

Standard Specifications * - No Up-Charge

Seat Width & Depth

Power Functions - Base

Floor to seat pan

Lower Leg Support Assembly

Footplate

Controller Electrics

Leg Support

Back Configuration

Controller Swing-Away / Dropdown

Stump Support

Arm Support

Pelvic Positioning Belt

Tyres

Seating Cushion

Seating - Back System

Headrest