Pride Mobility Jazzy Select Owner's manual

Brand: Pride Mobility

Model: Jazzy Select

Type: Owner's manual

Pride Mobility Jazzy Select is a mid-wheel drive power chair designed to provide mobility and independence for individuals with limited mobility. It features Active Trac suspension for a smooth ride, a GC3 joystick for easy control, and a 3.5-amp off-board charger for convenient charging. Choose from two seat options: Captain Seating or Solid Seat Pan Seating. Both come with adjustable armrests and a 60" lap belt. Additional accessories like leg rests, back-mounted accessories, and joystick mounting brackets can be added for enhanced functionality.

Page 1 of 3INFINFB4048/RevA/03FEB2020

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

2 0″ W × 1 8″ D ..........................................................................$275

Part: SETASMB3184

With 60″ Lap Belt

2 0″ W × 2 0″ D ..........................................................................$275

Part: SETASMB3185

With 60″ Lap Belt

Jazzy

Select Quick Ship Order Form

Account Number: ___________ Date: ________________

Provider Name: __________________________________

Contact: ________________________________________

Phone: ___________________ Fax: _________________

Email: _________________________________________

PO Number: _____________________________________

Marked for: _____________________________________

Ship to Address: _________________________________

City: _____________________ State: ______ Zip: ______

Jazzy Red

Part: DGN1806646

BASE COLOR

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

Jazzy Select-2S-C ............................................................$5,099

Part: JAZZY SELECT-2S-C. HCPCS: K0823

Captain Seating

Jazzy Select-2S-SS ..........................................................$5,099

Part: JAZZY SELECT-2S-SS. HCPCS: K0822

Solid Seat Pan Seating

Standard Features

• Mid-wheel drive technology

• Active Trac

suspension

• Height-adjustable foot platform

• 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-select.

INTRODUCTION

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!

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

Part: SET131843

With 60″ Lap Belt

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

Part: SET131844

With 60″ Lap Belt

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

Part: SET131845

With 60″ Lap Belt

Captain Seating — Depth-Adjustable, Comfort Seat, Limited Recline, High Back

Pride

Mobility Products Corporation

182 Susquehanna Ave., Exeter, PA 18643

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

Solid Seat Pan Seating

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

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

Additional lead time may apply.

SEATING

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

Page 2 of 3INFINFB4048/RevA/03FEB2020

Account Number: ___________ Date: ________________ Marked for: _____________________________________

Medium Weather Cover ......................................................$168

Part: ACCCOVR1022

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

Part: DWR1020D010

Cup Holder, Style B (Deluxe Contour Seat) ......................$20

Part: ACCASMB2287

Cup Holder, Style C (Comfort Seat) ....................................$20

Part: ACCASMB2288

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

Part: ACCASMB2629

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

Part: CTLDC1388

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

Part: ACC1704791

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

Part: KIT1805521

Used on Comfort Seats only — see SEATING on Page 1.

ACCESSORIES

Optional.

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

Comfort part: ACCASMB2537. Deluxe Contour part: ACCASMB1914

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

Comfort part: ACCASMB2540. Deluxe Contour part: ACCASMB2294

HCPCS: E2207

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

Comfort part: ACCASMB2651. Deluxe Contour part: ACCASMB2292

HCPCS: E2208

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

Comfort part: ACCASMB1912. Deluxe Contour part: ACCASMB2541

Back-Mounted Accessories

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

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

Part: KIT124479

HCPCS: K0195

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

Part: KIT124480

HCPCS: K0195

Elevating Leg Rests

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

Leg Rest Accessories

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

60° – 90° Swing-Away Leg Rests

Adjustable in 5° increments.

LEG RESTS

Optional.

BATTERIES

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

Battery, 33 Ah, U-1 ......................................................................................................................................................................... $133 ea.

Part: BAT1704611. HCPCS: E2365

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 part: FRMASMB16316

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

50″ Lap Belt ............ $39.90

Part: ACCBELT1000

70″ Lap Belt ............. $39.90

Part: ACCBELT1003

80″ Lap Belt ............ $39.90

Part: ACCBELT1004

90″ Lap Belt ............ $39.90

Part: ACCBELT1005

Additional Lap Belts

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

L R

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.

Page 3 of 3INFINFB4048/RevA/03FEB2020

Account Number: ___________ Date: ________________ Marked for: _____________________________________

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

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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REFERENCE ORDER FORMS

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

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:_______________

NOTES

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)

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

See cushion order form

L R

Pride Mobility Jazzy Select Owner's manual

Pride Mobility Jazzy Select Owner's manual

Pride Mobility Jazzy Select Owner's manual

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