Failure to use an order form for a Quickie chair order may result in delay or wrong shipment. Please ask for details on how to order

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1 ORDER FORM Quickie Failure to use an order form for a Quickie chair order may result in delay or wrong shipment Please send all orders to: Fax: +44 (0) orders@sunmed.co.uk Sunrise Medical Ltd Thorns Road, Brierley Hill, West Midlands, DY5 LD Standard Features: Foldable modular aluminium frame Height adjustable backrest with padded nylon upholstery Swingaway footrests 4" quickrelease rear wheels, pneumatic tyres, crossspoked Standard front seat height 49.5cm (19 5/8") Infinite centre point of gravity adjustment achieved with Rear seat height 47cm (18 1/4") slotted horizontal axle plate Low rider hemiframe available, 8" front castors with pneumatic tyres Front seat height 45cm (17 5/8") Wide choice of frame colours Rear seat height 4cm (16 1/4") Black anodised frame parts Minimum seat height 15" (38cm) This Quickie model is ideal in combination with a Jay seating Tension adjustable nylon seat upholstery and system 5cm (") seat cushion Weight 13kg Swingaway armrests Maximum user weight limit 113 kg How to measure: Seat Depth From front of seat sling to back of seat sling Seat Width From outside seat rail tube to outside seat rail tube SA Model Frame Length From outside rear frame to outside front frame Back Height From seat sling to top of backrest sling Prices: All prices are in Pounds Sterling and Euros and exclude VAT. For latest issue, please refer to Please consult Sunrise Medical with any queries you may have.

2 ORDER FORM Quickie Failure to use an order form for a Quickie chair order may result in delay or wrong shipment Please send all orders to: Fax: +44 (0) orders@sunmed.co.uk Please ask for details on how to order on Invoice to: Name: Street: Town: Postal Code: Country: Telephone: Fax: Ship to: Name: Street: Town: Postal Code: Country: Telephone: Fax: Order Date: Marked for: Sunrise Order No: Number Required: Please fill boxes, do not tick = Standard = Option = No Cost Option = Standard MODEL Quickie (Swingaway front frame) 1995 Quickie (Hemi front frame) 1995 FRAME COLOUR (Mark one box) Gloss Finish: Matt/Frost Finish: 3 Matt Silver 16 Matt Marine 73 1 White Ral Red Ruby 8 Matt Lime 0 Matt Purple 73 Brilliant Silver Brilliant Red 3 Matt Red 73 4 Silver 4 Tutti Fruitti Orange 5 Silver Moon 6 Silver Texture 6 Sun Yellow 7 Graphite Metallic 7 Brilliant Lime 8 Platinum Metallic 14 Blue 9 Black 14 Blue 15 Brilliant Marine 19 Brilliant Purple COLOURED CHAIR PARTS Coloured cross brace (Same colour as frame) Chair colour set (Castor fork, housing, cross brace, handrim, seat rails & axle plate) Colour (Mark one box): 3 Matt Silver 16 Matt Marine Matt Lime 0 Matt Purple Matt Candy Teal 3 Matt Red 143 FRAME WIDTH (Mark one box) Frame width 14"/ 35 cm Frame width 18"/ 45 cm Frame width 15"/ 37,5 cm Frame width 19"/ 47.5 cm Frame width 16"/ 40 cm Frame width 0"/ 50 cm Frame width 17"/ 4.5 cm REAR FRAME (Mark one box) Straight rear frame Rounded rear frame (11) (Lowest two axle positions and 0" wheels not available) FRAME LENGTH (Mark one combination of frame length and seat depth) Quickie Swingaway Front Frame: Frame length kids (Not available with 4" or 6" wheels) Seat depth 14"/35 cm Frame length reg Seat depth 15"/37,5 cm Seat depth 16"/40 cm Frame length long Seat depth 17"/4,5 cm Seat depth 18"/45 cm SEAT TYPE (Mark one cushion and sling choice) Cushion: Sling: Cushion "/ 5 cm Sling upholstery, tension adjustable Omit cushion 6 Omit sling upholstery 1 All prices are in Pounds Sterling and Euros and exclude VAT. For latest issue, please refer to Please consult Sunrise Medical with any queries you may have.

3 BACKREST (Mark one type and choices underneath) Straight backrest < Continued from left column Push handles (Mark one box): Back Height (Mark one box): With push handles Low 111"/830cm (F.S. 1"/30cm) (1) (Not available with stroller handles) Med 1415"/3538cm (F.S 15"/38cm) (1) Without push handles Tall 1618"/4046cm (F.S 17"/43cm) (1) Stroller handles (optional): Padded upholstery (Only w/out push handles) Optima back upholstery 103 Regular 138 (Tension adjustable, not w/o push handles or low height) (Mark one box) Continued in right column > 8º Bend backrest with push handles Half folding backrest with push handles Backrest angle (Mark one box): Padded upholstery Straight back tubes Optima back upholstery back tubes (Tension adj., not w/o push handles) Padded upholstery Back Height (Mark one box): Medium 1415"/3538cm (F.S 15"/38cm) (1) Back Height (Mark one box): Tall 1618"/4046cm (F.S 17"/43cm) (1) Low 1314"/3335cm (F.S. 14"/35cm) (1) (Not possible on 8º bend half folding back) Medium 1617"/4043cm (F.S 17"/43cm) (1) Tall 1819"/46cm (F.S 19"/cm) (1) Optima back with integrated height adjustable 93 Backrest with integrated height adjustable push handles 93 push handles, 1 angle adjustment Backrest angle (Mark one box): Backrest angle (Mark one box): Straight backrest straight back tubes 8º backrest 8 back tubes Padded upholstery Optima back upholstery (Tension adjustable) 103 Optima back upholstery 103 (Tension adjustable, with back stabiliser bar) Back Height (Standard): Medium Height (1) Back Height (Standard): (16"19"/40cm height adjustment, F.S. 16"/40 cm) Medium Height (16"19"/40cm height adjustment, F.S. 16"/40 cm) (1) ARMRESTS (Mark one box) Padded swing away armrest (pair) (7) Kids aluminium height adj. armrest w/10" std pad (pair) 118 (Not with optima backrest or amputee axle bracket) Kids aluminium height adj. armrest w/14" std pad (pair) 118 Adult composite height adj. w/10" std pad (pair) () 118 Tool height adjustable armrest w/10" std pad (pair) () Adult composite height adj. w/14" full length pad (pair) () 118 Tool height adjustable armrest w/14" long pad (pair) Aluminium adult height adj. w/10" std pad (pair) () 118 Omit armrest (pair) 47 Aluminium adult height adj. w/14" full length pad (pair) () 118 SIDE GUARDS (optional) Plastic side guards (pair) 137 Fender guards (pair) 176 (Not available in combination with height adjustable armrests) (Not on kids frame or in w/ height adjustable armrests) Fabric side guards HANGERS/FOOTPLATES/EXTENSION TUBES (Mark one type, continued on next page) 60º Hangers (pair) 70º Hangers (pair) One piece flipup angle adjustable with legstrap (pair) (3) 118 One piece flipup angle adjustable with legstrap (pair) (3) 118 Composite footplates with heel loops (pair) Composite footplates with heel loops (pair) Foam footplates with legstrap (pair) (3) Foam footplates with legstrap (pair) (3) Omit footplate (pair) Omit footplate (pair) Additional legstrap 5 Additional legstrap 5 Extension tubes short/medium (pair) Extension tubes short/medium (pair) Amputee Support Pad (is fitted to hanger and replaces footplate and ext. tube) (Optional): Amputee Support Pad (is fitted to hanger and replaces footplate and ext. tube) (Optional): Amputee support pad left 16 Amputee support pad left 16 Amputee support pad right 16 Amputee support pad right 16 All prices are in Pounds Sterling and Euros and exclude VAT. For latest issue, please refer to Please consult Sunrise Medical with any queries you may have.

4 HANGERS/FOOTPLATES/EXTENSION TUBES (Mark one type and choices underneath) Elevating legrest (pair) (not on hemi model) º VHangers (not available on hemi model) (Not available on hemi frame, not below seat width 16"/40 cm) Composite flipup footplates with heel loop (pair) 73 One piece flipup angle adjustable with legstrap (pair) 118 Omit footplates (pair) Composite footplates with heel loops (pair) Calf Pad: 73 Straight calf pad Foam footplates with legstrap (pair) (3) Curved calf pad Omit footplate (pair) Additional legstrap 5 Extension tubes short/medium (pair) Extension tubes short (pair) Extension tubes medium (pair) Articulating legrest (pair) (not on hemi model) 98 90º Hangers (pair) (not available on hemi model) (Not available with 6" wheels, 8" castors or hemi frame) Composite flipup footplates with heel loop (pair) Omit footplates (pair) 90º Adjustable flipup footplates with legstrap (pair) (3) Calf pad: Omit footplate (pair) Straight calf pad Additional legstrap 5 Extension tubes short (pair) Extension tubes medium (pair) CASTORS (Mark one box) 5" Solid (pair) 8" Solid castors (pair) () 5" Lowprofile polyurethane castors (pair) 8" Pneumatic castors (pair) () 6" Solid castors (pair) 8" x " Solid castors (pair) () 6" Pneumatic castors (pair) CASTORS (Mark one box) 5 1/4" Castor fork (pair) 7" Castor fork (pair) (9) 6" Castor fork (pair) 8" Castor fork (pair) (4, 9) CASTOR STEM (Optional) 3/4" Longer fork stem bolt (pair) 1 1/" Longer fork stem bolt (pair) AXLE PLATES (Mark one box) Slotted indexed horizontal axle plate (pair) Slotted horizontal amputee axle plate (pair) 5 Curved axle plate (pair) (Not with One Arm Drive) (Not with swingaway armrests or stroller handles) One arm drive axle plate (pair) (Standard) Quick Release axles (pair) DRIVE (Optional) One Arm Drive 85 Dual handrim mounted right hand side (Non quickrelease Mag wheels only) Inner handrim standard (Only in aluminium) Dual handrim mounted left hand side (Not available with 0" wheel) Inner handrim small All prices are in Pounds Sterling and Euros and exclude VAT. For latest issue, please refer to Please consult Sunrise Medical with any queries you may have.

5 REAR WHEEL SIZE/TYPE/TYRE/HANDRIM (Mark one type of wheel, size, tyre, handrim, and tab) Rear wheel size 0" Rear wheel size " Xspoke (pair) Mag (pair) Tyre Type: Xspoke (pair) Pneumatic tyre (pair) Tyre Type: Solid tyre (pair) (10) 3 Pneumatic tyre (pair) Handrims: Solid tyre (pair) (10) 3 Aluminium handrim (pair) Handrims: Plastic coated handrim (pair) 74 Aluminium handrim (pair) 9 Plastic coated handrim (pair) 74 Tabs: 9 Short tabs (pair) Tabs: Long tabs (pair) 47 Short tabs (pair) Long tabs (pair) 47 Rear wheel size 4" () Rear wheel size 6" () 5 Mag (pair) Xspoke (pair) Xspoke (pair) Tyre Type: Tyre Type: Pneumatic tyre (pair) Pneumatic tyre (pair) High pressure clincher (pair) Solid tyre (pair) (10) 3 Handrims: High pressure clincher (pair) Aluminium handrim (pair) (Not available on Mag wheel) Plastic coated handrim (pair) 74 Handrims: 9 Aluminium handrim (pair) Tabs: Plastic coated handrim (pair) 74 Short tabs (pair) Stainless steel handrim (pair) (8) 8 Long tabs (pair) 47 Foam grip handrim (pair) (8) Tabs: Short tabs (pair) Long tabs (pair) 47 WHEEL LOCKS (Mark one box) High push knee lever wheel locks (pair) Active wheel lock High scissor wheel locks (pair) Drum brakes (pair) (5) 301 (Not on Kids frame, ext. handles) (Not available with Mag wheels) WHEEL LOCK (Optional) 6" Wheel lock extension (pair) 33 ACCESSORIES (Optional) Caddy (pair) (6) Step tube left (7) 8 Crutch holder 54 Step tube right (7) 8 Spoke guards Space Alien ", 4" (pair) (8) 100 Backpack Spoke guards Purple Turtle ", 4" (pair) (8) 100 Seat pouch 41 Spoke guards Get Out There ", 4" (pair) (8) 100 Positioning belt buckle 64" 34 Spoke guards Leopard ", 4" (pair) (8) 100 Positioning belt buckle 54" 34 Spoke guards clear ", 4" (pair) 93 Swingaway tray table 155 Spoke guards black ", 4" (pair) 93 (Only available on height adjustable armrests) Neoprene impact guards (pair) (6) 9 Antitip tubes (pair) 61 Tool kit 1 F16 power unit (Please fill out F16 order form as well. See F16 order form for restrictions that apply on Quickie specification when ordering F16) Base Price: 1,995 Options: Total Price: All prices are in Pounds Sterling and Euros and exclude VAT. For latest issue, please refer to Please consult Sunrise Medical with any queries you may have.

6 REAR SEAT HEIGHT Axle Plate Position " Pneumatic 18 7/8" 17 7/8" 16 5/8" 15 1/" 14 3/8" 0" Full poly tyres 18 5/8" 17 1/" 16 1/4" 15 1/4" 14 1/8" " Pneumatic 19 3/4" 18 5/8" 17 1/" 16 3/8" 15 1/4" " Solid Tyre 19 3/4" 18 5/8" 17 1/" 16 5/8" 15 1/4" 4" Solid Tyre 0 3/4" 19 5/8" 18 1/" 17 5/8" 16 1/4" 6" Pneumatic 1 3/4" 0 5/8" 19 1/" 18 5/8" 17 1/4" Actual measurements may vary up to 3/8" Based on standard axle plate / standard frame Curved axle plate / standard frame:+1"; reversed:1" Curved axle plate / curved rear frame: Add 1/8" for quick release stems. Hemi front frame: Subtract " Front Seat Height Fork Size 5 1/4" Fork 6" Fork 7" Fork Fork Position Bottom Top Bottom Top Bottom Top Castor Type 5" Polys / Solid Tyre 6" Solid Tyre 6" Pneumatic 8" Solid Tyre 8" Pneumatic 18 1/16" 18 5/8" 18 5/8" 19 5/8" 17 1/16" 17 5/8" 17 5/8" 18 7/8" 0 1/4" 0 7/16" 17 7/8" 18 7/16" 18 7/16" 19 1/4" 19 7/8" 0 7/16" 0 7/16" 18 7/8" Spec. Overall Chair Width Measurements are based on standard stem: 14" width " (55cm) Add ¾" for ¾" stem 15" width 3" (57.5") Add 1½" for 1½" stem 16" width 4" (60cm) 17" width 5" (6.5cm) 18" width 6" (65cm) 19" width 7" (67.5cm) 0" width 8" (70cm) FOOTNOTES: (1) F.S = Factory Setting. If you would like to have the chair supplied with another back height please order in conjunction with the Specials Department Order Form () Not available on Kids frame (3) Not available with heel loops (4) Not available on Kids frame (Only with 8x" castor, only with 60 hangers, not on 70 front frame) (5) When drum brakes plus other brakes are ordered, the spares prices for other brakes applies (6) Not available with ELR/ALR or 90 hangers (7) Not available with rounded rear frame (8) Not available on Mag wheels (9) When selected in conjunction with 70º hangers, reg frame & 8" castors, the fork touches the rear wheel, therefore it is recommended to select 60º hangers to avoid this conflict. (10) Not available with Scissor wheel locks due to poor hold performance (11) Not available with hemi frame All prices are in Pounds Sterling and Euros and exclude VAT. For latest issue, please refer to Please consult Sunrise Medical with any queries you may have.

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