Wheelchair Manufacturers in Canada | Wheelchair Canada

FULL FORM BACK

Online quote form

STANDARD SIZES

Gentle Fit Back Custom Width:*

Gentle Fit Back Custom height:*

Gentle Lateral Custom:*

ADDITIONAL OVERLAYS

SHUDOLV1 Visco Overlay Half (3 Pieces)

SHUDOLV2 Visco Overlay Full (6 pieces)

SHUDOLG1 Gel Overlay Half (3 Pieces)

SHUDOLG Gel Overlay Full (6 Pieces)

PIN OPTIONS?

COVER OPTIONS

EXTRA COVER*

SHUDCOV3 Standard Cover

SHUDCOV4 TEK4 Infection Control Complete Cover

SHUDCOV8 TEK4 Infection Control 4" Bottom Protector

SHUDCOV5 Custom Cover

*Note: Please enter the size above for standard or custom cover

Custom Cover:*

Custom Cover sizes:* *Note: Please enter the size above for standard or custom cover

Additional Notes

Final Total

First Name*

Last Name*

Company Name:*

Phone Number:*

Official Work Email*
Location:*