Pride Mobility Victory 9 Owner's manual

Page 1 of 2INFINFB3724/RevD/03FEB2020

Victory

9 Quick Ship Order Form — 3-Wheel and 4-Wheel Scooters

Pride

Mobility Products Corporation

182 Susquehanna Ave., Exeter, PA 18643

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: ______

High Back, Deluxe Contour, 18″W × 18″D ........................ $600

Part: SET134626

High Back, Deluxe Contour, 18″W × 20″D ....................... $600

Part: SET134627

OPTIONAL SEATING

Select one seat.

COLOR

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

Candy Apple Red

SC609 part: SHDASMB5308

SC709 part: SHDASMB5338

Large Black Weather Cover ........ $202

Part: ACCCOVR1018

Medium Black Weather Cover .... $158

Part: ACCCOVR1019

Cell Phone Holder .......................... $70

Par t: ACC145549

Rearview Mirror .............................. $25

Part: LGTRMIR1003

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

Part: DWR1020D010

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

Used on Deluxe Contour Seat

Part: ACCASMB2287

Cup Holder, Style C ....................... $20

Used on Standard Foldable Seat

Part: ACCASMB2288

Safety Flag ...................................... $38

Part: ACCASMB2079

ACCESSORIES

Optional. See Page 2 for back-mounted accessories.

MODEL

REQUIRED. Weight capacity: 300 lbs. Find more specications at pridemobility.com/victory-9-3-wheel or pridemobility.com/victory-9-4-wheel.

Victory 9 3-Wheel............................................................ $2,259

Part: SC609. HCPCS: K0800, Standard/Group 1

Victory 9 4-Wheel............................................................ $2,419

Part: SC709. HCPCS: K0800, Standard/Group 1

Standard Features

• Two U-1 batteries

• 3.5-amp o-board charger

• Front basket

• Foldable seat with sliders

(18″ W × 17″ D )

• LED headlight

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g-

ured as a complete scooter. Pride Providers may contact Technical Services for accurate parts ordering.

Thank you for choosing Pride Mobility Products!

INTRODUCTION

Page 2 of 2INFINFB3724/RevD/03FEB2020

Pride

Mobility Products Corporation

182 Susquehanna Ave., Exeter, PA 18643

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

Account Number: ___________ Date: ________________ Marked for: _____________________________________

COMMENTS

BRANCH PATCHES

Optional.

Air Force Patch ............................... $20

Part: ACC140240

Army Patch ..................................... $20

Par t: ACC140241

Coast Guard Patch ........................ $20

Par t: ACC140239

Marines Patch ................................. $20

Par t: ACC140243

Navy Patch ...................................... $20

Par t: ACC140244

Purple Heart Patch ........................ $20

Part: ACC140238

CANE/CRUTCH HOLDER

Optional. Only one cane/crutch holder can be used at a time.

Wishbone Crutch Holder .................................................... $98

Part: FRMASMB2358

Quad Cane Holder ............................................................... $98

Part: ACCASMB1931

Forearm Crutch Holder ....................................................... $98

Part: ACCASMB1019

Single Rear Mount, 3″ ...........................................................$70

Part: ACCINDV1058

Double Rear Mount, 3″ .........................................................$70

Part: ACCINDV1019

Cane Clip Attachment (Quantity of 2 Required) .......... $8 ea.

Used on Standard Foldable Molded Plastic Seats with Sliders

Part: ACCINDV1074

LAP BELTS

Optional.

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

Part: ACCBELT1000

60″ Lap Belt ...............................$39.90

Part: ACCBELT1002

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

Part: ACCBELT1003

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

Rear Basket (15.25″ × 9.75″ × 9.5″) .. $80

Part: ACCBSKT1010

Oxygen Tank Holder ...................... $98

Part: ACCASMB1017

Walker Holder ................................. $98

Part: ACCASMB1018

BACK-MOUNTED ACCESSORIES

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Pride Mobility Victory 9 Owner's manual

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