Pride Mobility Jazzy Elite ES Owner's manual

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
S
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″ Oset ................................................. $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
© 2020 Pride Mobility Products Corp. All rights reserved.
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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:
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Pride Mobility Jazzy Elite ES Owner's manual

Type
Owner's manual

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