Mark For. Phone. Ship to Name. Shipping Address. The product in the picture has extra equipment.

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1 Clear Form Zitzi STAFISH PO Date Quote equest Only Mark For Order Form Phone PO# Company Name Ship to Name Address Shipping Address City State Zip City State Zip NEW UCT! POD Combined showerand hygiene chair 3 TYPES OF CHASSIS: 2 TYPES OF SEAT PATS: Included in standard edition: Whole Chassis with 4 wheels Divided Seat part with cushion Back part with push bar Bracket for the pot The product in the picture has extra equipment. Starfish Pro The seat height can be adjusted in fixed positions (without tools) for a seat height ranging between 20.6 and Starfish Pro Hydraulic Height adjustable hydraulic chassis for a seat height ranging between 20.6 and Starfish Pro Electric Height adjustable electric chassis for a seat height ranging between 20.6 and L SPECIA E D O L SPECIA E D O 1

2 1 Chassis* Z Starfish Pro, Seat size 1 Z Starfish Pro, Seat divided size 1 Z * Starfish Pro Hydraulic, Seat size 1 Z * Starfish Pro Hydr. Seat divided size 1 Z * Starfish Pro Electric, Seat size 1 Z * Starfish Pro Elec., Seat divided size 1 STAFISH PO SIZE 1 User length: Seat depth: Seat width, whole: Seat width, divided: Tilt: Hip/back angle: Chassis WxL: 21 x 26.9 Max user weight: lb (Man. chassis) lb (Hydr./El.) Z Starfish Pro, Seat size 2 Z Starfish Pro, Seat divided size 2 Z * Starfish Pro Hydraulic, Seat size 2 Z * Starfish Pro Hydr. Seat divided size 2 Z * Starfish Pro Electric, Seat size 2 Z * Starfish Pro Elec., Seat divided size 2 STAFISH PO SIZE 2 User length: Seat depth: Seat width, whole: 17.5 Seat width, divided: Tilt: Hip/back angle: Chassis WxL: 21 x 26.9 Max user weight: lb (Man. chassis) lb (Hydr./El.) 2 Z Starfish Pro, Seat size 3 Z Starfish Pro, Seat divided size 3 Z * Starfish Pro Hydraulic, Seat size 3 Z * Starfish Pro Hydr. Seat divided size 3 Z * Starfish Pro Electric, Seat size 3 Z * Starfish Pro Elec., Seat divided size 3 * Special Order Back* Z Back size 1 Z Back size 2 Z Back size 3 Z Back with sacrum support STAFISH PO SIZE 3 User length: Seat depth: Seat width, whole: 19.9 Seat width, divided: Tilt: Hip/back angle: Chassis WxL: 23 x 30.8 Max user weight: lb (Man. chassis) lb (Hydr./El.) Back part incl cushion Size 1: Back height: 17.9 Back profile: 19.5 Size 2: Back height: 21.8 Back profile: 23.4 Size 3: Back height: 25.7 Back profile: 27.3 Back with sacrum support 3 Lateral support* Z Lateral support size 1 Z Lateral support size 2 Z Lateral support size 3 Z Lateral support reinforced size 1 Z Lateral support reinforced size 2 Z Lateral support reinforced size 3 Size 1: Trunk width: Trunk depth: 5.4 Size 2: Trunk width: Trunk depth: 6.6 Size 3: Trunk width: Trunk depth: 7.8 2

3 4 Headrest* Z Headrest size 1, long cpl. Z Headrest size 2, cpl. Z Headrest size 2, long cpl. Z Mounting bracket Active forehead strap Z77101 Active forehead strap, Adult Z77102 Active forehead strap, Junior 5 Armrest Headrest Headrest long A B Size 1 long: 10.9 x 6.2 Size 2: 9.3 x 7.4 Size 2 long: 10.9 x 8.2 Active forehead strap A B Choose armrest size 1 for Starfish Pro size 1 & 2, and armrest size 2 for Starfish Pro size 3. Z Armrest back size 1 Z Armrest back size 2 Z Armrest back size 3 Z Soft cushion size 1 Z Soft cushion size 2-3 Z Armrest chassis size 1 Z Armrest chassis size 2 Measurements armrest plate back: Size 1: 8.9 x 2.9 Size 2-3: 12.8 x 2.9 Armrest back Measurements armrest plate chassi: Size 1-2: 10.5 x 1.9 Mounted in the chassis. Stays fixed during tilt. Armrest chassi 6 Table Z Table size 2 Z Table size 3 Z Table size 4 Z Table size 5 Table Size 2 Size 3 Size 4 Size 5 Trunk width Positioning support Z Sternum support Soft Blue size S Z Sternum support Soft Blue size M Z Sternum support Soft Blue size L Z H-strap Soft Blue size S Z H-strap Soft Blue size M Z H-strap Soft Blue size L Upper mounting bracket Sternum support Articles above needs to be combined with Z Upper mounting bracket, long H-strap 3

4 8 Leg positioning/hip support Z Leg. pos. out div. size 1 Z Leg. pos. out div. size 2 Z Leg. pos. out div. size 3 Z Leg. pos. in div. size 1 Z Leg. pos. in div. size 2 Z Leg. pos. in div. size 3 Z Leg. pos. out whole. size 1 Z Leg. pos. out whole. size 2 Z Leg. pos. out whole. size 3 Z Hip support size 1-2 Z Hip support size 3 Leg. pos. in Measurements: Size 1: 5.8 x 8.2 Size 2: 6.6 x 9.3 Size 3: 7 x 10.9 Leg. pos. out 9 Hip belt* Z SeatBelt Comfort Blue size S, DWS25 Z SeatBelt Comfort Blue sizes, 725 Seatbelt Comfort Z SeatBelt Comfort Blue size M, DWS40 Z SeatBelt Comfort Blue size M, S40 Z SeatBelt Comfort Blue size M, 740 Z SeatBelt Comfort Blue size L, DSW40 Z SeatBelt Comfort Blue size L, S40 Z SeatBelt Comfort Blue size L, 740 Z SeatBelt Blue size S, DWS25 Z SeatBelt Blue size S, 725 Z SeatBelt Blue size M, DWS40 Z SeatBelt Blue size M, S40 Z SeatBelt Blue size M, 740 Z SeatBelt Blue size L, DWS40 Z SeatBelt Blue size L, S40 Z SeatBelt Blue size L, 740 Z Anti-rotational belt Blue size S, DWS25 Z Anti-rotational belt Blue size S, 725 Z Anti-rotational belt Blue size M, DWS40 Z Anti-rotational belt Blue size M 740 Seatbelt Pro Anti-rotational belt Buckle DWS25/ DWS40 Buckle 740 Buckle S40 Buckle 725 4

5 10 Ankle holder/bracelet Z Ankle holder Soft Blue size S Measurements around Z Ankle holder Soft Blue size M ankle Z Ankle holder Soft Blue size L size S 6.2 x 9.3 size M 8.5 x 10.9 size L 10.1 Z Bracelet Soft Blue size S Z Bracelet Soft Blue size L Ankle holder 11 Footrest* Z Footrest size 1 Z Footrest size 2 Z Footrest size 3 Z Footrest divided size 1 Z Footrest divided size 2 Z Footrest divided size 3 Z Footrest tip-up size 1 Z Footrest tip-up size 2 Z Footrest tip-up size 3 Z Footrest divided tip-up size 1 Z Footrest divided tip-up size 2 Z Footrest divided tip-up size 3 Z Footrest divided ball joint size 1 Z Footrest divided ball joint size 2 Z Footrest divided ball joint size 3 Z Cushion footrest size 1 Z Cushion footrest size 2 Z Cushion footrest size 3 Z Cushion footrest divided size 1 Z Cushion footrest divided size 2 Z Cushion footrest divided size 3 FOOTEST Footrest Footrest divided Footrest tip-up Footrest divided tip-up Footrest divided ball joint Cushion footrest Cushion footrest divided Foot plate (W x D) Footrest size x 8.7 Footrest size x 9.9 Footrest size x 12 Foot plate (W x D) Footrest divided size x 8.5 Footrest divided size 2 7 x 9.9 Footrest divided size 3 7 x 11.9 Profile length

6 12 Calf support Z Calf support size 1 Z Calf support size 2 Z Calf support size 3 Z Cushion calf support size 1 Measurements Size x 5.4 Size x 5.8 Size x 5.8 Z Cushion calf support size 2 Z Cushion calf support size 3 Calf support and cushion 13 Cushion seat part; extra pressure relief Z Cushion seat part, extra pressure relief size 1 Z Cushion seat part, extra pressure relief size 2 Z Cushion seat part, extra pressure relief size 3 Cushion with extra pressure relief. 1 material instead of the standard 1/2 Z Cushion seat part, extra pressure relief size 1 divided Z Cushion seat part, extra pressure relief size 2 divided Z Cushion seat part, extra pressure relief size 3 divided 14 Pot/splash guard Z Pot size 1 cpl. - Starfish Pro Z Pot size 2 cpl. - Starfish Pro Z Splash guard - Starfish Pro Pot Splash guard Pot size 1 fits Starfish Pro size 1 & 2, pot size 2 fits Starfish Pro size 3. * ecommended parts to assemble basic chair. 6

7 Spare parts Z Z Z Z Z Z Z Z Z Z Z Cushion Back size 1 - Starfish Pro Cushion Back size 2 - Starfish Pro Cushion Back size 3 - Starfish Pro Cushion seat size 1 - Starfish Pro Cushion seat size 2 - Starfish Pro Cushion seat size 3 - Starfish Pro Cushion seat div. size 1 - Starfish Pro Cushion seat div. size 2 - Starfish Pro Cushion seat div. size 3 - Starfish Pro Cushion, headrest size 1 long Cushion, headrest size 2 long Z Cushion, headrest size 2 Z Cushion, leg abduction size 1 Z Cushion, leg abduction size 2 Z Cushion, leg abduction size 3 Z HoIe fili Legpart Z Cushion, leg addduction size 1 Z Cushion, leg addduction size 2 Z Cushion, leg addduction size 3 Note: Not all items are stocked. Inquire about availability when quoting. 7

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