Power Wheelchair Retail Prescription Form TDXSP2NB231118 Tel: 01656 776222 Fax: 01656 776220 Email: [email protected] Online Spares available at: www.invacare.co.uk Delivery Address : Order Qty : Order Date : Standard Features • • • • • • • • • Max Seating System Compact, manoeuvrable, CWD TDX SP2 Seat Widths from 490mm ‐ 610mm Seat Depths 560mm ‐ 630mm Tension Adjustable backrest Armrest with reinforced depth adjustable bracket with Short armpad Manual settable seat Tilt Manual settable backrest Recline VARI F Hangers with fixed footplate Standard Base Price £5,905 X Please make your selection with a cross in the box * Configurations may vary from the image shown Standard feature TDX SP2 Special Model - PLEASE COMPLETE DETAILS AT THE END OF THE FORM SEATING TYPE : 'MAX' ADJUSTABLE SEATING SYSTEM ARH1145 SEAT WIDTH SETTING (3 x SEAT FRAMES) ARH0348 Seat Width of Seat Frame 550mm (+100mm adjustment in arms) Seat Width of Seat Frame 610mm (+100mm adjustment in arms) Seat Width of Seat Frame 490mm (+100mm adjustment in arms)  Not available with Vari F legrest SEAT DEPTH SETTING (SETTABLE IN 3 STEPS) ARH0396 Order Number:

Order Number: Subject to Invacares standard terms conditions. Invacare reserve the right to alter product specification without prior notice.

Order Number: Subject to Invacares standard terms conditions. Invacare reserve the right to alter product specification without prior notice.

Order Number: Subject to Invacares standard terms conditions. Invacare reserve the right to alter product specification without prior notice.

TOTAL PRICE Order Number: Subject to Invacares standard terms conditions. Invacare reserve the right to alter product specification without prior notice.

Need a different option not on the form? Take a look at our Powerchair Alternative Options form, available as standard Powerchair Alternative Option required: Please refer to our Invacare Unique special order form, for more complex custom requirements. Available at www.invacare.co.uk Special Instructions - Please supply the following information: Name: Description of special request (please include relevant option code or part number): Order Number: Subject to Invacares standard terms conditions. Invacare reserve the right to alter product specifi