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Revo 2.0 3-Wheel ............................................................ $2,419
Part: S66. HCPCS: K0899 — Power mobility device, not coded by DME
PDAC or does not meet criteria.
Revo 2.0 4-Wheel ............................................................ $2,489
Part: S67. HCPCS: K0899 — Power mobility device, not coded by DME
PDAC or does not meet criteria.
Revo
®
2.0 3-Wheel and 4-Wheel Scooter — Quick Ship Order Form
INTRODUCTION
This form is interactive when viewed in Adobe Acrobat Reader and may not function correctly if opened with applications other than Acrobat.
All prices are MSRP. Prices, specications, part numbers, and availability are subject to change without notice. Prices and part numbers as shown are only
available when congured as a complete scooter. Pride Providers may contact Technical Service for accurate parts ordering.
Thank you for choosing Pride
®
Mobility Products!
Account Number: ___________ Date: ________________
Provider Name: __________________________________
Contact: ________________________________________
Phone: ___________________ Fax: _________________
Email: __________________________________________
PO Number: _____________________________________
Marked for: _____________________________________
Ship to Address: _________________________________
City:_________________ Prov:______ Postal:__________
MODEL
REQUIRED. Weight capacity: 400 lbs. Find more specications at pridemobility.com/revo-2.0-3-wheel or pridemobility.com/revo-2.0-4-wheel.
Standard Features
• Two U-1 AGM batteries
• 3.5-amp o-board charger
• Front basket
• LED headlight
• Foldable seat (20″W × 18″D)
• Under-seat storage
• Integrated USB charger
• Integrated XLR charging port
ACCESSORIES
Optional.
Medium Weather Cover ......................................................$158
Part: ACCCOVR1019
Cup Holder, Style D ............................................................. $20
Part: ACC120041
Cell Phone Holder .................................................................$70
Part: ACC145549
Rearview Mirror .................................................................... $25
Part: LGTRMIR1003
Saddle Bag (12.5″ × 9.875″) .................................................. $35
Part: DWR1020D010
Safety Flag ............................................................................ $38
Part: ACCASMB2079
Rear Basket ( 1 5 . 2 5″ × 9 . 7 5 ″ × 9 . 5″ ) ..$80
Part: ACCBSKT1010
Oxygen Tank Holder ...................... $98
Part: ACCASMB1017
Walker Holder ................................. $98
Part: ACCASMB1018
True Blue
3-Wheel Part: DGN1706292
4-Wheel Part: DGN1706215
Grey Street
3-Wheel Part: DGN1709744
4-Wheel Part: DGN1709738
COLOR
REQUIRED. Colors shown here may dier from actual product depending on monitor/printer calibration.
Back-Mounted Accessories
Optional. Only one back-mounted accessory can be used at a time. Includes mounting bracket and hardware.
Pride
®
Mobility Products Corporation
401 York Ave., Duryea, PA 18642
Phone: 1-800-800-8586 | Fax: 1-800-800-1636 | Email: prideorders@pridemobility.com