Pride Mobility Jazzy Elite ES Portable Owner's manual

Brand: Pride Mobility

Model: Jazzy Elite ES Portable

Type: Owner's manual

Pride Mobility Jazzy Elite ES Portable is a power wheelchair designed to provide mobility and independence to users with limited mobility. It features a front-wheel drive system for enhanced maneuverability in tight spaces and a GC3 joystick for precise control. The adjustable seat and armrests ensure a comfortable and customizable experience, while the 3-amp off-board charger makes it easy to keep the batteries charged.

Page 1 of 3INFINFB3769/RevG/03FEB2020

Jazzy

Elite ES Portable 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 color. Colors shown here may dier from actual product depending on monitor/printer calibration.

Jazzy Elite ES Portable 2S-P-C .................................... $5,099

Part: JELITEES-P 2S-P-C. HCPCS: K0821

Captain Seating

Jazzy Elite ES Portable 2S-P-SS .................................. $5,099

Part: JELITEES-P 2S-P-SS. HCPCS: K0820

Solid Seat Pan Seating

Standard Features

• Front-wheel drive

• GC3 joystick

• In-line joystick mounting bracket

• 3-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-portable.

INTRODUCTION

Depth-Adjustable, Comfort Seat, Limited Recline, High Back

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

Part: SETASMB2775

With 60″ Lap Belt

Deluxe Contour, Limited Recline, High Back

Additional lead time may apply.

Pride

Mobility Products Corporation

182 Susquehanna Ave., Exeter, PA 18643

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

1 6″ W × 1 6″ – 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 × 1 8 ″ – 2 0″ D ................... Standard

Part: SET131845

With 60″ Lap Belt

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!

SEATING

Optional. Select one seat. Seats come with a 60″ lap belt. See Page 2 for more seating options.

Captain Seating

Page 2 of 3INFINFB3769/RevG/03FEB2020

Account Number: ___________ Date: ________________ Marked for: _____________________________________

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

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.

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

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

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

Part: SETASMB3179

With 60″ Lap Belt

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

Addtional lead time may apply.

Solid Seat Pan Seating

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.

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

1 6″ W × 1 6″ – 18 ″ D ..........................................................Standard

Part: SET145814

With 60″ Lap Belt

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

Part: SET145815

With 60″ Lap Belt

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

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)

SEATING Continued

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

UNOCCUPIED TIE-DOWN KIT

Optional. Applies only to Comfort Seats — see SEATING on Pages 1-2.

Unoccupied Tie-Down Kit ....................................................................................................................................................................$100

Part: KIT1805521

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 3INFINFB3769/RevG/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

youtube.com/

pridemobility

facebook.com/

PrideMobilityProductsCorp

twitter.com/

pridemobility

instagram.com/

PrideMobilityProducts

REFERENCE ORDER FORMS

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

50″ Lap Belt ............................... $39.90

Part: ACCBELT1000

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.

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.

See cushion order form

Synergy Seat (Not a Quick Ship option)

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

Part: ACCCOVR1022

Cup Holder ............................................................................. $20

Style C, Comfort part: ACCASMB2288

Style B, Deluxe Contour part: ACCASMB2287

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

Comfort part: ACCASMB2629

Deluxe Contour part: ACCASMB1930

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

Part: CTLDC1388

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

Part: ACCASMB2580

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

Part: ACC1704791

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

Part: DWR1020D010

ACCESSORIES

Optional.

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