Order form – Cat I

Order number:
Order Date:
Company name / Name and surname*
Bill adress:*
E-mail:*
Phone*
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Click if:
Ship to:
Shipment adress:
Contact:
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Ship product:*
Product size*

Choose upholstery:

Upholstery colours:*

Standard Equipment

  • Frame with castors and brakes
  • Footplate with foot support and belts
  • Gas spring
  • Abduction block
  • Chest and pelvic pads with safety belts
  • Chest and pelvic supports
  • Tray with plate
  • Tray pad
  • Breathable upholstery ATMO™ - Gras

Accessories:

Safety:
Positioning:
Comfort:
Storage:
Message to us: