#Live Inspired www.inspiredbydrive.com 11724 WILLAKE STREET | SANTA FE SPRINGS, CA 90670 562.282.0244 | 800.454.6612 | F:310.305.1718

Spirit™ Car Seat U.S. Patent No. D636,190S STANDARD MODEL FEATURES • • • • • • • Support users up to 66” in height and up to 130 lb in weight Low profile sides for easy transfer of users Durable, machine-washable padded cover Memory foam back/seat padding reduces sores and fatigue Soft-padded headwings Latex and silicone free Crash tested to FMVSS #213 PLUS MODELS FEATURE 1. Swing-Away Padded Trunk Support s 2. Swing-Away Padded Hip Supports 3. Swing-Away Abductor Dune Buggy Beige (CC) Incontinence Covers 3-inch Extensor Thrust Wedge Buckle Guard

ORDER FORM Dealer: Date: Phone: FAX TO 310-305-1718 OR SUBMIT ONLINE Account #: Ordered By: E-mail: _ PLUS PACKAGE COMPONENTSSeat Depth Extender 0 Select to have PLUS components itemized on quote. (quote will show standard car seat, CSS-2400S, + components) Hip Bracket (price per unit, 2 per car seat) Hip Pad (price per unit, 2 car seat) Trunk Bracket (price per unit, 2 car seat) Trunk Pad (price per unit, 2 car seat) UPHOLSTERY Convertible Pink with Gray Mesh Dune Buggy Beige with Gray Mesh Go Kart Green with Gray Mesh Roadster Red with Black Mesh Speedway Gray with Gray Mesh ACCESSORIES Extensor...

2000 IPS Car Seat FEATURES • Accommodate users weighing 20 - 102 lb and up to 60” tall • Durable, machine washable, comfortable padded cover in five color options • Crash tested to FMVSS #213 • Certified for use in aircraft • Positioning options available • Optional seat depth extender allows car seat to grow with the child INCLUDES • Independently adjustable height had pads or soft-padded headwings • Memory foam back/seat padding reducs sores and fatigue • Standard 5-point harness restraint for better protection than vehicle lap/shoulder belt • Crotch strap pad • Lateral positioning pads...

Dealer: Date: Phone: Account #: Ordered By: E-mail: _ BASE UNIT Convertible Pink with Gray Mesh Dune Buggy Beige with Gray Mesh Go Kart Green with Gray Mesh Roadster Red with Black Mesh Speedway Gray with Gray Mesh ACCESSORIES (fit both car seats) Seat Depth Extender O CSI-A2025 Extend to 12.5" $165 Abductor W> CSI-A2015 For standard seat depth $395 Extensor Thrust Wedge (_.) CSI-A2050 2" Wedge $125 Block Style Trunk Support Pads (2 each of 1 .5" and 2.5" thick pads) (_) CSI-A2008 $40 Bolt-in Hardware Kit with Strap(for vehicle manufactured before 2002) (_) CSI-A2031 $90...

Trotter Wheelchair STANDARD MODEL FEATURES • Available in 4 different seat width options - 12”, 14”, • • • • • • • • 16”, and 18” Lightweight folding frame with closure strap that holds the chair shut when folded Black removable and washable fabric Crash tested for transit with optional transit brackets Adjustable back angle - 85°,90°, and 95° 8” front casters and 10” rear wheels with toggle lock Adjustable-seat depth Curb-assist lever facilitates curbside navigation Pelvic belt and five-point harness included Curb Assist Lever at rear wheels UPHOLSTERY OPTIONS Headrest Extension Padded Headrest...

ORDER FORM |FAXnOt3nfflB3HMBnNnflraRRUflMnnOnITN^^^^^^^M Er>°** ric«pcr>p»« I'liiin mmyi Account #: Ordered By: E-mail: _ Dealer: Date: Phone: HCPCS codes are not intended to be, nor should be considered billing or legal advice. Providers are responsible for determining the appropriate billing codes when submitting claims. Referenced HCPCS codes are also not guarantee of payment. BASE UNIT OPTIONAL SEAT & BACK UPHOLSTERY Coral Rose Headrest Extension TR 8021 E0966 Padded Headrest Wing O TR 8022 E1399 Upper Extremity Support/Tray O TR 8024 E0950 Full Torso Vest O TR...

Wallaby Pediatric Folding Wheelchair FEATURES • Available in Two Seat Widths - 12” and 14” • Standard Transit Tie Down Brackets • WC19 Compliant when used with WB8021 for users • • • • • • between 50 and 80 lbs. Height adjustable push handles Flip back padded desk arms Pelvic belt standard Push to lock wheel locks 22” Rear wheels with 6” front casters Swingaway footrests with tool free height adjustment and calf strap 12” W wheelchair only available in Red 14” W wheelchair only available in Blue Flip-Back Padded Desk Length Arms Push-to-Lock Brakes Headrest Extension

ORDER FORM FAX TO 310-305-1718 OR SUBMIT ONLINE EMAIL FORM PRINT FORM Dealer: Date: Phone: Account #: Ordered By: E-mail: _ BASE UNIT Seat Dimensions Weight Capacity Weight Capacity with Transit Option Overall Open Width Overall Closed Width Seat-to-Floor Height Seat-to-Footrest Height Back Height Push Handle Height Armrest Height Overall Legth with Footrests Overall Lenght withoug Footrests Product Weight with Footrests Product Weight withoug Footrests HCPCS Code HCPCS codes are not intended to be, nor should be considered billing or legal advice. Providers are responsible for determining the...

Forearm Crutches Ergonomic Armcuffs FEATURES • Now available in 3 different sizes • Each size is available in 3 different colors • Height adjustable in 1” increments • Separately Adjustable cuff height • Full style, composite cuffs Smooth Hand Grips fo

ORDER FORM |FAXnORn0B30MBn7nflraRRUflMnnOninH^^^^^^^M Er>P** himhi<>nn/i Dealer: Date: Phone: Account #: Ordered By: E-mail: _ BASE UNIT Product Size Weight Capacity User Height Floor-to-Grip Height Grip-to-Top of Cuff Cuff Diameter Cuff Style Product Weight HCPCS Code HCPCS codes are not intended to be, nor should be considered billing or legal advice. Providers are responsible for determining the appropriate billing codes when submitting claims. Referenced HCPCS codes are also not guarantee of payment. COLOR Knight Blue (B) Prices listed are subject to change without notice. © 2017 Inspired...