Pride Mobility Jazzy Elite HD Owner's manual

Brand: Pride Mobility

Model: Jazzy Elite HD

Type: Owner's manual

Page 1 of 3INFINFB3771/RevE/03FEB2020

Jazzy

Elite HD 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: SHDASMB7120084

Jazzy Blue

Part: SHDASMB7120085

BASE COLOR

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

ELITE HD

Jazzy Elite HD 2HD-C ..................................................... $5,299

Part: JELITEHD 2HD-C. HCPCS: K0825

Captain Seating

Jazzy Elite HD 2HD-SS ................................................... $5,299

Part: JELITEHD 2HD-SS. HCPCS: K0824

Solid Seat Pan Seating

Standard Features

• Front-wheel drive

• Angle-adjustable foot platform

• 60-amp Dynamic Shark joystick

• In-line joystick mounting bracket

• 5-amp o-board charger

• Flat-free tires

BASE MODEL

REQUIRED. Select a power base. Weight capacity: 450 lbs. Find more details and specications at pridemobility.com/jazzy-elite-hd.

INTRODUCTION

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

HCPCS codes provided should not be considered as legal advice and do not guarantee reimbursement. DME providers are responsi-

ble 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!

Pride

Mobility Products Corporation

182 Susquehanna Ave., Exeter, PA 18643

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

Captain Seating — Depth-Adjustable, Fold Flat, Limited Recline, High Back

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

1 8 ″ W × 1 8 ″ D ..................................................................Standard

Part: SETASMB2848

With 60″ Lap Belt

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

Part: SETASMB3182

With 60″ Lap Belt

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

Part: SETASMB6895

With 60″ Lap Belt

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

Part: SETASMB6896

With 60″ Lap Belt

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

Part: SETASMB6897

With 70″ Lap Belt

SEATING

REQUIRED. Select one seat. Seats come with a lap belt. Maximum weight capacity is 400 lbs. when seat is set at 18″D.

Page 2 of 3INFINFB3771/RevE/03FEB2020

Account Number: ___________ Date: ________________ Marked for: _____________________________________

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

Part: ACCCOVR1022

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

Part: DWR1020D010

Cup Holder, Style B ..............................................................$20

Part: ACCASMB2287

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

Part: ACCASMB1930

Dynamic Programmer ........................................................$423

Part: ELEASMB4352

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

Part: RIGASMB7120041

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

Part: ACCASMB2580

ACCESSORIES

Optional.

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

Part: ACCASMB1914

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

Part: ACCASMB2294. HCPCS: E2207

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

Part: ACCASMB2292. HCPCS: E2208

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

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: FRMASMB3810. HCPCS: K0195

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

Part: FRMASMB3806. 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° – 9 0 ° Swing-Away Leg Rests

Adjustable in 5° increments.

LEG RESTS

Optional.

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 Quick Ship orders.

NF-22, 55 Ah ................................................................................................................................................................................... $330 ea.

Part: BATLIQ1018. HCPCS: E2361

ARMRESTS

REQUIRED. The armrests are automatically selected with Quick Ship orders.

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

Left part: FRMASMB8614. Right: FRMASMB8615

HCPCS: E0973

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 3INFINFB3771/RevE/03FEB2020

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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instagram.com/

PrideMobilityProducts

NOTES

REFERENCE ORDER FORMS

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

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

Left part: ACC148368. Right part: ACC148369

HCPCS: E1028

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

Left part: ACC148370. Right part: ACC148371

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)

Special Measurement Seat

SPECIAL MEASUREMENT SEAT

Optional. May increase lead time. Seat size cannot exceed 24″W × 24″D. Contact your inside sales specialist for pricing.

Width:______ Depth:______ Seat Type:_______________

See cushion order form

Synergy Seat (Not a Quick Ship option)

LAP BELTS

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

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: ACCBELT1001

Account Number: ___________ Date: ________________ Marked for: _____________________________________

Pride Mobility Jazzy Elite HD Owner's manual

Brand: Pride Mobility

Model: Jazzy Elite HD

Type: Owner's manual

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Pride Mobility Jazzy Elite HD Owner's manual

Pride Mobility Jazzy Elite HD Owner's manual

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