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Orion II Order Form

Orion II — Tilt-in-Space Wheelchair

Custom Configuration Order Form  |  DME Superstore  

TEL: 888-376-1658
support@dmesuperstore.com

1

Frame Type

Orion II — Max weight 250 lbs, 45° tilt ORIONII250 E1161
$2,750.00
Orion II Heavy Duty — Max weight 350 lbs, 45° tilt ORIONII350 E1161
$3,100.00
R. Add 8" to seat width on finished product (handrim to handrim).
2

Tilt Option

Power Tilt 101MA31 E1002
$2,000.00
M. Weight capacity with Power Tilt is 250 lbs. Power Tilt can only be placed on chairs with seat width 15"–20". Provides approx. 42° of infinite tilt (3° to 45°). Cannot be used with recline options.
3

Frame Finish


Wet Black
Standard

Silver
+$350.00

Blue
No Charge

Green
+$350.00

Orange
+$350.00

Purple
+$350.00

Red
No Charge

Yellow
+$350.00
4

Seat Width

15" 101SW15
No Charge
16" 101SW16
No Charge
17" 101SW17
No Charge
18" 101SW18
Standard
19" 101SW19
No Charge
20" 101SW20 E2201
$395.00
21" (Up to 350 lbs) 101SW21 E2201
$395.00
22" (Up to 350 lbs) 101SW22 E2201
$395.00
23" (Up to 350 lbs) 101SW23 E2201
$395.00
24" (Up to 350 lbs) 101SW24 E2202
$600.00
A. Heavy Duty Package consisting of gusseted frame.
5

Seat Depth

15" 101SD15
No Charge
16" 101SD16
Standard
17" 101SD17
No Charge
18" 101SD18
No Charge
19" 101SD19
No Charge
20" 101SD20 E2203
$511.00
21" (Up to 350 lbs) 101SD21 E2203
$511.00
22" (Up to 350 lbs) 101SD22 E2204
$855.00
23" (Up to 350 lbs) 101SD23 E2204
$855.00
24" (Up to 350 lbs) 101SD24 E2204
$855.00
6

Seat Pan Options

No Seat Pan 101SE2
No Charge
Solid Seat Pan 101SE1 E2231
$165.00
7

Seat to Floor Height

13.25" (16" Wheels & 4" casters) 101STF96
No Charge
13.25" (20" Wheels & 4" casters) 101STF01
No Charge
14.5" (16" Wheels & 5" casters) 101STF97
No Charge
14.5" (20" Wheels & 5" casters) 101STF02
No Charge
15" (20" Wheels & 5" casters) 101STF03
No Charge
15.5" (22" Wheels & 5" casters) 101STF25
No Charge
15.5" (12" Wheels & 6" casters) 101STF26
No Charge
16" (20" Wheels & 5" casters) 101STF27
No Charge
16" (12" Wheels & 6" casters) 101STF28
No Charge
16" (24" Wheels & 6" casters) 101STF29
No Charge
16" (22" Wheels & 6" casters) 101STF06
Standard
16.5" (24" Wheels & 6" casters) 101STF30
No Charge
16.5" (24" Wheels & 7" casters) 101STF31
No Charge
16.5" (22" Wheels & 7" casters) 101STF08
No Charge
17" (24" Wheels & 7" casters) 101STF32
No Charge
17" (22" Wheels & 8" casters) 101STF33
No Charge
18" (16" Wheels & 8" casters) 101STF98
No Charge
18" (24" Wheels & 8" casters) 101STF11
No Charge
19" (24" Wheels & 8" casters) 1" Spacer 101STF34
$175.00
20" (24" Wheels & 8" casters) 2" Spacer 101STF35
$175.00
C. Only available with pull to lock brakes.  |  D. With 12" rear wheel, only push to lock brakes available.
8

Rear Wheel Rim

Mag Wheels 101RW09
Standard
Spoke Wheels 101RW10
$255.00
9

Rear Wheel Tire

Airless (Solid Rubber) 101RT1
Standard
Pneumatic 101RT2 E2211
$60.00
10

Axle Type

Fixed Rear Axle 101AL2
Standard
Quick Release Axle 101AL1
No Charge
11

Handrim

Chrome 101HR1
Standard
Plastic Coated 101HR2
$90.00
12

Trigger Location

Push Cane 101TH1
No Charge
Stroller Bar 101TH2
Standard
13

Arm Type

T-Style Adj. Height Knob Release (Standard) 101AR04 E0973
$210.00
T-Style Flip Back Adj. Height Knob Release 101AR10 E0973
$295.00
14

Arm Pad Type

Desk Length Vinyl 10" (pair) 101AP1
No Charge
Full Length Vinyl 14" (pair) 101AP2
Standard
Contour Gel 17" (pair) 101AP3
$100.00
Contour Gel Wide 16" (pair) 101AP4
$150.00
15

Seat to Back Angle

83°
No Charge
90°
No Charge
97°
Standard
104°
No Charge
111°
No Charge
16

Back Post

Canes & Stroller Bars Fixed 20" Height 101SP1
No Charge
Canes & Stroller Bars Fixed 25" Height 101SP2
No Charge
Canes & Stroller Bars Fold Down 20" Height 101SP3
$150.00
Canes & Stroller Bars Fold Down 25" Height 101SP4
$150.00
Stroller Bars Fixed 20" Height 101SH1
No Charge
Stroller Bars Fixed 25" Height 101SH2
No Charge
Stroller Bars Adj. Angle Fold Down 20" Height 101SH3
$150.00
Stroller Bars Adj. Angle Fold Down 25" Height 101SH4
$150.00
Stroller Bars Adj. Hinged Low 20" Height 101SH5
Standard
Stroller Bars Adj. Hinged High 25" Height 101SH7
Standard
Canes & Stroller Bars Recline 20" Height 101SP5 E1225
$600.00
Canes & Stroller Bars Recline 25" Height 101SP6 E1225
$600.00
B. Recline options cannot be used with the Power Tilt option.
17

Back Options

No Back 101BK49
Standard
Prism Orion Back 14"–20" wide 101OB14-20 E2615
$450.00
Prism Basic Back 14"–20" wide 101BB14-20 E2620
$615.00
Prism Basic Back 22"–24" wide 101BB22-24 E2621
$750.00
Prism Ultra Back 14"–20" wide 101UB14-20 E2620
$615.00
Prism Ultra Back 22"–24" wide 101UB22-24 E2621
$750.00
Prism Air Back 14"–20" wide 101AB14-20 E2615
$655.00
Prism Air Back 22"–24" wide 101AB22-24 E2616
$755.00
Prism TrueFitt Back 14"–20" wide 101TFB14-20 E2615
$625.00
Prism TrueFitt Back 22"–24" wide 101TFB22-24 E2616
$725.00
Max Ultra Back 14"–20" wide 101MUB14-20 E2620
$645.00
Max Ultra Back 22"–24" wide 101MUB22-24 E2621
$695.00
Max Air Back 14"–20" wide 101MAB14-20 E2620
$725.00
Max Air Back 22"–24" wide 101MAB22-24 E2621
$755.00
Max TrueFitt Back 14"–20" wide 101MTFB14-20 E2620
$675.00
Max TrueFitt Back 22"–24" wide 101MTFB22-24 E2621
$725.00
Lunar Back Low No Lateral 14"–20" 10LBSNL14-20 E2620
$595.00
Lunar Back Low Basic Lateral 14"–20" 101LBSBL14-20 E2620
$670.00
Lunar Back Mid No Lateral 14"–20" 101MBSNL14-20 E2620
$645.00
Lunar Back Mid Basic Lateral 14"–20" 101MBSBL14-20 E2620
$720.00
Lunar Back Mid Ultra Lateral 14"–20" 101MBSUL14-20 E2620
$795.00
Lunar Back Full No Lateral 14"–22" 101FBSNL16-22 E2620/21
$695.00
Lunar Back Full Basic Lateral 14"–22" 101FBSBL16-22 E2620/21
$770.00
Lunar Back Full Ultra Lateral 14"–22" 101FBSUL16-22 E2620/21
$845.00
Lunar Back Custom 14"–22" 101LUNARCUS E2620/21
$950.00
18

Back Pins

Standard Pins
Standard
Longer Pins 1" Growth 101BP1
$50.00
Longer Pins 2" Growth 101BP2
$50.00
E. Use for mounting back 1" wider than chair.  |  F. Use for mounting back 2" wider than chair. Select only if backrest is a different size than the chair.
19

Seat Cushion

No Cushion
Standard
Serene Prime 16"–20" 101SC20
$100.00
Serene Prime 22"–24" E2601
$140.00
Serene Paramount 16"–20" E2605
$300.00
Prism Ideal 16"–20" E2601
$100.00
Prism Ideal 22"–24" E2602
$175.00
Prism Elite 16"–20" E2603
$225.00
Prism Elite 22"–24" E2604
$300.00
Prism Supreme 16"–20" E2607
$365.00
Prism Supreme 22"–24" E2608
$495.00
Prism Supreme II Plus 16"–20" E2607
$385.00
Prism Supreme II Plus 22"–24" E2608
$425.00
Prism Supreme Air 16"–20" E2624
$475.00
Prism Supreme Air 22"–24" E2625
$495.00
Prism Supreme Gel 16"–20" E2607
$395.00
Prism Supreme Gel 22"–24" E2602
$525.00
21

Front Rigging

700 Pin Style 101FR01
No Charge
800 Pin Style 101FR02
No Charge
600 Swingaway 101FR03
No Charge
700 Swingaway Upgraded 101FR04
Standard
900 Swingaway 101FR05
No Charge
Swingaway Elevating Legrest (pair) 101FR10 E0990
$275.00
No Front Rigging 101FR11
No Charge
No Footrest Hanger 101FR12
No Charge
22

Footplate

Composite Flip Up Small 101FP01
No Charge
Composite Flip Up Medium 101FP02
No Charge
Composite Flip Up Large 101FP03
No Charge
Composite Angle Adj. Flip Up Small 101FP28 K0040
$120.00
Composite Angle Adj. Flip Up Medium 101FP29 K0040
$120.00
Composite Angle Adj. Flip Up Large 101FP30 K0040
$120.00
Aluminum Flip Up Small 101FP05
No Charge
Aluminum Flip Up Medium 101FP06
No Charge
Aluminum Angle Adj. Flip Up Small 101FP10 K0040
$140.00
Aluminum Angle Adj. Flip Up Medium 101FP11 K0040
$140.00
Aluminum Angle Adj. Flip Up Large 101FP12 K0040
$140.00
One Piece Footboard 15"–20" 101FP19
$160.00
One Piece Footboard 21"–24" Custom 101FP20
$195.00
One Piece Footboard, Padded 101FP26
$210.00
Foam Pad One Piece Footboard 101FP27
$250.00
23

Footrest / Legrest Accessories

Heel Loops 101FA01 E0951
$40.00
No Heel Loops 101FA02
No Charge
Padded Calf Strap 101FA03 K0038
$45.00
Swingaway Calf Pad (pair) 101FA04
$185.00
Foam Guard on Elevating Legrest (pair) 101FA05
$95.00
Foam Pad on Footplate (pair) 101FA07
$95.00
24

Wheel Locks

Push to Lock 101WL1
No Charge
Push to Lock + Extension 101WL3 E0961
$60.00
Pull to Lock 101WL2
No Charge
Pull to Lock + Extension 101WL4 E0961
$60.00
Attendant Wheel Lock RT (Foot Activated) 101WL8
$195.00
Attendant Wheel Lock LT (Foot Activated) 101WL9
$195.00
Unilateral Push Wheel Lock RT 101WL10
$250.00
Unilateral Push Wheel Lock LT 101WL11
$250.00
Unilateral Pull Wheel Lock RT 101WL12
$250.00
Unilateral Pull Wheel Lock LT 101WL13
$250.00
Berner Push Wheel Lock 101WL14
$95.00
Berner Pull Wheel Lock 101WL15
$95.00
25

Headrest Hardware

Omit Headrest Hardware 101HE99
Standard
Fixed Headrest Curved 101HE15 E1028
$195.00
Fixed Headrest Curved (+4") 101HE16 E1028
$200.00
Single Multi Axial Curved 101HE17 E1028
$175.00
Single Multi Axial Curved (+4") 101HE18 E1028
$200.00
Dual Multi Axial Curved 101HE19 E1028
$225.00
Dual Multi Axial Curved (+4") 101HE20 E1028
$250.00
Infinite Multi Axial Curved 101HE22 E1028
$250.00
Infinite Multi Axial Curved (+4") 101HE24 E1028
$270.00
Links Multi Adj. Hardware (2 links) 101HE10 E1028
$200.00
Links Multi Adj. Curved Hardware (2 links) 101HE11 E1028
$240.00
Additional Link 101HE12 E1028
$50.00
2 Additional Links 101HE13 E1028
$100.00
3 Additional Links 101HE14 E1028
$150.00
26

Headrest Adaptor Brackets

Universal Headrest Bracket Assembly 101HEBA E1028
$86.00
27

Headrest Foam Pad

Omit Headrest Foam Pad 101HE09
Standard
Pro-Fit Small 101HF12 E0955
$175.00
Pro-Fit Medium 101HF13 E0955
$180.00
Pro-Fit Large 101HF14 E0955
$185.00
28

Anti Tip

Quick Flip Anti Tipper 101MA23 E0971
$120.00
29

Positioning Strap

Auto 101MA03 E0978
$124.00
Airline 101MA04 E0978
$76.00
Velcro 101MA05 E0978
$48.00
30

Attachment Tie Down

Front & Rear Transit Hooks 101MA30
$250.00
N. Transit Hooks can only be used on Orion II wheelchairs up to 350 lbs weight capacity. Tested per ANSI/RESNA WC/19.
31

Miscellaneous Accessories

Tilt Locking Collar 101MA01
$20.00
Recline Locking Collar 101MA02
$20.00
Foam Pad on Arm Guard 101MA06 E0978
$76.00
Padded Lap Tray 15"–16" 101MA09 E0950
$230.00
Padded Lap Tray 17"–18" 101MA10 E0950
$230.00
Padded Lap Tray 19"–20" 101MA11 E0950
$385.00
Padded Lap Tray 21"–22" 101MA12 E0950
$385.00
Padded Lap Tray 23"–24" 101MA13 E0950
$385.00
Half Padded Lap Tray, Left Side 101MA14 E0950
$350.00
Half Padded Lap Tray, Right Side 101MA15 E0950
$350.00
Elbow Stop, Left 101MA16 K0108
$94.00
Elbow Stop, Right 101MA17 K0108
$94.00
Shoulder Lateral Pad (each) 101MA18
$90.00
IV Pole, Telescopic 101MA20 E0776
$175.00
Oxygen Tank Holder 101MA21 E2208
$175.00
Adductor Pad 10W x 4.5H Flush Hooks (pair) 101MA24
$175.00
Adductor Pad 10W x 4.5H Offset Hooks (pair) 101MA25
$175.00
Adductor Pad 12W x 4.5H Flush Hooks (pair) 101MA26
$175.00
Adductor Pad 12W x 4.5H Offset Hooks (pair) 101MA27
$175.00
Adductor Pad 14W x 4.5H Flush Hooks (pair) 101MA28
$175.00
Adductor Pad 14W x 4.5H Offset Hooks (pair) 101MA29
$175.00
Spoke Guards 20", 22", or 24" wheels 101MA49
$130.00
K. Only available with Stroller Bar push option.
✎

Additional Notes

Submitting this form sends your configuration to DME Superstore for review.
Prices are subject to change without notice. A representative will follow up to confirm your order.
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