Pride Mobility Jazzy Elite ES Owner's manual

Brand: Pride Mobility

Model: Jazzy Elite ES

Type: Owner's manual

Page 1 of 4

INFINFB3712/RevH/03FEB2020

1 6″ W × 16″ – 1 8 ″ D .................. Standard

Part: SET131843

With 60″ Lap Belt

1 8″ W × 18″ – 2 0″ D .................. Standard

Part: SET131844

With 60″ Lap Belt

2 0″ W × 1 8 ″ – 2 0″ D .................. Standard

Part: SET131845

With 60″ Lap Belt

Jazzy

Elite ES Quick Ship Order Form

Account Number: ___________ Date: ________________

Provider Name: __________________________________

Contact: ________________________________________

Phone: ___________________ Fax: _________________

Email: __________________________________________

PO Number: _____________________________________

Marked for: _____________________________________

Ship to Address: _________________________________

City: _____________________ State: ______ Zip: ______

Candy Apple Red

Part: DGN1702485

Viper Blue

Part: DGN1702484

BASE COLOR

REQUIRED. Select one shroud color. Colors shown here may dier from actual product depending on monitor/printer calibration.

Jazzy Elite ES 2S-C ........................................................ $5,099

Part: JELITEES 2S-C. HCPCS: K0823

Captain Seating

Jazzy Elite ES 2S-SS ...................................................... $5,099

Part: JELITEES 2S-SS. HCPCS: K0822

Solid Seat Pan Seating

Standard Features

• Front-wheel drive

• GC3 joystick

• In-line joystick mounting bracket

• 3.5-amp o-board charger

BASE MODEL

REQUIRED. Select a power base. Weight capacity: 300 lbs. Find more details and specications at pridemobility.com/jazzy-elite-es.

INTRODUCTION

SEATING

Optional. Select one seat. Seats come with a 60″ lap belt. See Page 2 for more seating options.

Pride

Mobility Products Corporation

182 Susquehanna Ave., Exeter, PA 18643

Phone: 1-800-800-8586 | Fax: 1-800-800-1636 | Email: prideorders@pridemobility.com

Depth-Adjustable, Comfort Seat, Limited Recline, High Back

1 8″ W × 16″ D ............................................................................................................................................................................................$450

Part: SETASMB2775

With 60″ Lap Belt

Deluxe Contour, Limited Recline, High Back

Additional lead time may apply.

This form is interactive when viewed in Adobe Acrobat Reader and may not function correctly if opened with applications other than Acrobat.

HCPCS codes provided should not be considered as legal advice and do not guarantee reimbursement. DME providers are responsible for determining

the appropriate billing codes when submitting for insurance reimbursement. Payer coding, coverage, and bundling guidelines may apply. All prices are

MSRP. Prices, specications, part numbers, and availability are subject to change without notice. Prices and part numbers as shown are only available

when congured as a complete power chair. Pride Providers may contact Technical Services for accurate parts ordering.

Thank you for choosing Pride Mobility Products!

Captain Seating

Page 2 of 4

INFINFB3712/RevH/03FEB2020

SEATING Continued

Optional. Select one seat. Seats come with a 60″ lap belt.

Solid Seat Pan Seating

1 6″ W × 16″ – 1 8 ″ D ....................................................... Standard

Part: SET145814

With 60″ Lap Belt

1 8″ W × 18″ – 2 0″ D ....................................................... Standard

Part: SET145815

With 60″ Lap Belt

Depth-Adjustable, Comfort Seat, Limited Recline, High Back, with Solid Seat Pan

ARMRESTS

REQUIRED. The armrests are automatically selected with a Quick Ship order based on seat selection above.

Flip-up, Height-Adjustable, Full-Length Armrests ................................................................................................................. $85 ea.

Comfort Seat Left part: FRMASMB16315. Right: FRMASMB16316

Deluxe Contour Left part: FRMASMB8614. Right: FRMASMB8615. HCPCS: E0973

Deluxe Contour, Limited Recline, High Back, with Solid Seat Pan

Additional lead time may apply.

1 6″ W × 16″ D ....................................................................... $450

Part: SETASMB3178

With 60″ Lap Belt

1 6″ W × 18″ D ....................................................................... $450

Part: SETASMB3179

With 60″ Lap Belt

Swing-Away Leg Rest with 7.25″ × 6″ Foot Plates (pair) .. $162

Part: RIG133656

Swing-Away Leg Rest with 8.5″ × 6″ Foot Plates (pair) .... $162

Part: RIG133659

Elevating Leg Rest with 7.25″ × 6″ Foot Plates (pair) ...... $325

Part: KIT124479 HCPCS: K0195

Elevating Leg Rest with 8.5″ × 6″ Foot Plates (pair) ....... $325

Part: KIT124480 HCPCS: K0195

Residual Limb Support ......................................... $325 ea.

Left part: FRMASMB5301. Right part: FRMASMB5300

HCPCS: E1020

Heel Loops (pair) .................................................................. $50

ELR part: FRMASMB1503. S/A part: FRMASMB7873

HCPCS: E0951

60° – 90° Swing-Away Leg Rests

Adjustable in 5° increments.

Elevating Leg Rests

Leg Rest Accessories

LEG RESTS

Optional. Some adjustments may be needed upon receipt of the unit.

Match seat width and depth — see cushion order form or

cushion part number:

Non-matching cushion size — see cushion order form or

cushion part number:

CUSHION QUICK PICK

Optional. Refer to the specic cushion order form for pricing, sizes, codes, and part numbers. If the cushion size matches the selected seat size,

check Match seat width and depth. If the cushion size diers from the seat size, check Non-matching cushion size. Attach the cushion order

form, or ll in the cushion part number below.

BATTERIES

REQUIRED. The Power Chair requires two batteries. The batteries are automatically selected with a Quick Ship order.

U-1, 27Ah .........................................................................................................................................................................................$133 ea.

Part: BATLIQ1026. HCPCS: E2365

Account Number: ___________ Date: ________________ Marked for: _____________________________________

Air Force Patch ............................... $20

Part: ACC140240

Army Patch ..................................... $20

Part: ACC140241

Coast Guard Patch ........................ $20

Part: ACC140239

Marines Patch ................................. $20

Part: ACC140243

Navy Patch ...................................... $20

Part: ACC140244

Purple Heart Patch ........................ $20

Part: ACC140238

Page 3 of 4

INFINFB3712/RevH/03FEB2020

Account Number: ___________ Date: ________________ Marked for: _____________________________________

ACCESSORIES

Optional.

Rear Basket (15.25″ × 9.75″ × 9.5″) ......................................$118

Deluxe Contour part: ACCASMB1914. Comfort part: ACCASMB2537

Cane/Crutch Holder ............................................................$110

Deluxe Contour part: ACCASMB2294. Comfort part: ACCASMB2540

HCPCS: E2207

Oxygen Tank Holder ........................................................... $118

Deluxe Contour part: ACCASMB2292. Comfort part: ACCASMB2651

HCPCS: E2208

Walker Holder ......................................................................$103

Deluxe Contour part: ACCASMB2541. Comfort part: ACCASMB1912

Back-Mounted Accessories

Optional. Only one back-mounted accessory can be used at a time. Includes mounting bracket and hardware.

Swing-Away, In-line ..................................................... $245

Left part: ACC148364. Right part: ACC148365

HCPCS: E1028

Swing-Away, 1″ Oset ................................................. $245

Left part: ACC148366. Right part: ACC148367

HCPCS: E1028

JOYSTICK MOUNTING BRACKETS

Optional. The power chair comes standard with an in-line joystick mounting bracket. Additional brackets may be selected below.

Swing-Away Joystick

In-line Mount (Right)

Swing-Away Joystick

Offset Mount (Right)

BRANCH PATCHES

Optional.

Air Force Patch ............................... $20

Part: ACC140240

Army Patch ..................................... $20

Part: ACC140241

Coast Guard Patch ........................ $20

Part: ACC140239

Marines Patch ................................. $20

Part: ACC140243

Navy Patch ...................................... $20

Part: ACC140244

Purple Heart Patch ........................ $20

Part: ACC140238

60″ Lap Belt........Standard

Part: ACCBELT1002

70″ Lap Belt .............$39.90

Part: ACCBELT1003

80″ Lap Belt ............$39.90

Part: ACCBELT1004

90″ Lap Belt ............$39.90

Part: ACCBELT1001

LAP BELTS

Optional. Seats come with a 60″ lap belt. An additional lap belt may be selected below.

Weather Cover, Medium, Black .........................................$168

Part: ACCCOVR1022

Saddle Bag (12.5″ × 9.875″) .................................................. $35

Part: DWR1020D010

Cup Holder ............................................................................ $20

Style B, Deluxe Contour part: ACCASMB2287

Style C, Comfort part: ACCASMB2288

Flag Holder ........................................................................... $25

Deluxe Contour part: ACCASMB1930. Comfort part: ACCASMB2629

PP1 Programmer ................................................................ $423

Part: ELEASMB4352

Bell-Shaped Foot Platform ............................................... $235

Part: RIGASMB7120041

Height-Adjustable Foot Platform Bracket ........................ $50

Part: ACCASMB2580

XLR USB Charger ................................................................ $38

Part: ACC1704791

Unoccupied Transit Kit ......................................................$100

Part: KIT1805521

Used on Comfort Seats only — see SEATING on Pages 1-2.

Page 4 of 4

INFINFB3712/RevH/03FEB2020

Account Number: ___________ Date: ________________ Marked for: _____________________________________

Pride

Mobility Products Corporation

182 Susquehanna Ave., Exeter, PA 18643

Phone: 1-800-800-8586 | Fax: 1-800-800-1636 | Email: prideorders@pridemobility.com

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NOTES

REFERENCE ORDER FORMS

Optional. Select below to note that additional order forms will accompany this order form.

See cushion order form

Synergy Seat (Not a Quick Ship option)

Special Measurement Seat

SPECIAL MEASUREMENT SEAT

Optional. Special measurement seats are not available as a Quick Ship order. Seat size cannot exceed 20″W × 20″D. Contact your inside sales

specialist for pricing.

Width: Depth: Seat Type:

Pride Mobility Jazzy Elite ES Owner's manual

Brand: Pride Mobility

Model: Jazzy Elite ES

Type: Owner's manual

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Pride Mobility Jazzy Elite ES Owner's manual

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