Pride Mobility Jazzy Elite 14 Owner's manual

Page 1 of 3INFINFB3715/RevF/17JUL2020

Jazzy Elite 14 2S-C ......................................................... $5,099

Part: JELITE14 2S-C. HCPCS: K0823

Captain Seating

Jazzy Elite 14 2S-SS ....................................................... $5,099

Part: JELITE14 2S-SS. HCPCS: K0822

Solid Seat Pan Seating

Jazzy

Elite

14 Order Form, Quick Ship

Pride

Mobility Products Corporation

401 York Avenue, Duryea, PA 18642

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

Account Number: ___________ Date: ________________

Provider Name: __________________________________

Contact: ________________________________________

Phone: ___________________ Fax: _________________

Email: __________________________________________

PO Number: _____________________________________

Marked for: _____________________________________

Ship to Address: _________________________________

City: _____________________ State: ______ Zip: ______

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!

INTRODUCTION

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.

BASE MODEL

REQUIRED. Select a power base. Weight capacity: 300 lbs. Find more details and specications at pridemobility.com/jazzy-elite-14.

Standard Features

• Front-wheel drive

• Angle-adjustable foot platform

• Flat-free tires

• In-line joystick mounting bracket

• 5-amp o-board charger

• 50-amp Dynamic Shark joystick

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

With 60″ lap belt

Part: SETASMB6895

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

With 60″ lap belt

Part: SETASMB6896

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

With 70″ lap belt

Part: SETASMB6897

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

With 60″ lap belt

Part: SETASMB2770

SEATING

REQUIRED. Select one seat. Seats come with a lap belt. See Page 2 for solid seat pan seating.

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

Captain Seating (Limited Recline, High Back)

Page 2 of 3INFINFB3715/RevF/17JUL2020

Account Number: ___________ Date: ________________ Marked for: _____________________________________

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 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

LEG RESTS

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

60° – 90° Swing-Away Leg Rests

Adjustable in 5° increments.

Elevating Leg Rests

Leg Rest Accessories

BATTERIES

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

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

Part: BATLIQ1018. HCPCS: E2361

ACCESSORIES

Optional. See Page 3 for back-mounted accessories.

Weather Cover, Medium, Black ... $168

Part: ACCCOVR1022

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

Part: DWR1020D010

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

Part: RIGASMB7120041

Foot Platform Bracket ..................... $50

Height-Adjustable

Part: ACCASMB2580

Dynamic Programmer ..................$650

Part: ELEASMB4352

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

Part: ACCASMB2287

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

Deluxe Contour part: ACCASMB1930

Depth-adjustable part: ACCASMB1907

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

Part: ACC1704791

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

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

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

ARMRESTS

REQUIRED. The armrests are automatically selected with a Quick Ship order.

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.

SEATING Continued

REQUIRED. Select one seat. Seats come with a lap belt.

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

With 60″ lap belt

Part: SETASMB3178

* 1 6 ″ W × 1 8″ D .................................. $450

With 60″ lap belt

Part: SETASMB3179

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

With 60″ lap belt

Part: SETASMB2848

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

With 60″ lap belt

Part: SETASMB3182

* 2 0 ″ W × 1 8 ″ D .................................. $450

With 60″ lap belt

Part: SETASMB3184

* 2 0 ″ W × 2 0 ″ D .................................. $450

With 60″ lap belt

Part: SETASMB3185

Solid Seat Pan Seating (Deluxe Contour, Limited Recline, High Back)

Additional lead time may apply.*

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 3INFINFB3715/RevF/17JUL2020

Account Number: ___________ Date: ________________ Marked for: _____________________________________

JOYSTICK MOUNTING BRACKETS

Optional. The power chair comes 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

Pride

Mobility Products Corporation

401 York Avenue, Duryea, PA 18642

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 22″W × 22″D. Contact your inside sales

specialist for pricing.

Width:______ Depth:______

Seat Type:_______________

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

ADDITIONAL LAP BELTS

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

70″ Lap Belt ................................ $39.90

Part: ACCBELT1003

80″ Lap Belt ............................... $39.90

Part: ACCBELT1004

90″ Lap Belt ............................... $39.90

Part: ACCBELT1005

See cushion order form

Synergy Seat (Not a Quick Ship option)

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

Deluxe Contour part: ACCASMB1914

Depth-adjustable part: FRMASMB1280

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

Deluxe Contour part: ACCASMB2294

Depth-adjustable part: FRMASMB1270. HCPCS: E2207

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

Deluxe Contour part: ACCASMB2541

Depth-adjustable part: FRMASMB1271

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

Deluxe Contour part: ACCASMB2292

Depth-adjustable part: FRMASMB1269. HCPCS: E2208

BACK-MOUNTED ACCESSORIES

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

Pride Mobility Jazzy Elite 14 Owner's manual

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