Quote for the WABSY brake system

Hidden

1. Contact informations

Name(Required)

First Last

You are requesting a quote for...(Required)

Your company's name(Required)

Institution's name(Required)

Do you already have an account with us?(Required)

Yes

Will the shipping address be the same as the billing address?(Required)

Yes

Shipping and billing adress

Adress City State/ Province ZIP/ Postal Code Country

Shipping adress

Adress City State/ Province ZIP/ Postal Code Country

Billing adress

Adress City State/ Province ZIP/ Postal Code Country

Phone number

Email(Required)

Enter Email Confirm Email

Hidden

2. Choice of your retailer

Country in which the system will be delivered(Required)

Province(Required)

State(Required)

Your Quebec retailer(Required)

The distributors that appear in the list below are located in Quebec. You can also choose Pratiko (Quebec, Canada).

Your Ontario retailer(Required)

The distributors that appear in the list below are located in Ontario. You can also choose Pratiko (Quebec, Canada).

Your New-Brunswick retailer(Required)

The distributors that appear in the list below are located in New Brunswick. You can also choose Pratiko (Quebec, Canada).

Your Alberta retailer(Required)

The distributors that appear in the list below are located in Alberta. You can also choose Pratiko (Quebec, Canada).

Your British Columbia retailer(Required)

The distributors that appear in the list below are located in British Columbia. You can also choose Pratiko (Quebec, Canada).

Your Manitoba retailer(Required)

The distributors that appear in the list below are located in Manitoba. You can also choose Pratiko (Quebec, Canada).

Your Nova Scotia retailer(Required)

The distributors that appear in the list below are located in Nova Scotia. You can also choose Pratiko (Quebec, Canada).

Your Saskatchewan retailer(Required)

The distributors that appear in the list below are located in Saskatchewan. You can also choose Pratiko (Quebec, Canada).

Your retailer(Required)

Your province does not have a local distributor at this time. Pratiko will take care of you.

Your France retailer(Required)

The distributor that appears in the list below is located in France. You can also choose Pratiko (Quebec, Canada).

Your Ireland retailer(Required)

The distributor that appears in the list below is located in Ireland. You can also choose Pratiko (Quebec, Canada).

Your Massachusetts retailer(Required)

The distributors that appear in the list below are located in Massachusetts. You can also choose Pratiko Medical (Lyndon, Vermont)

Your Wisconsin retailer(Required)

The distributors that appear in the list below are located in Wisconsin. You can also choose Pratiko Medical (Lyndon, Vermont)

Your North Carolina retailer(Required)

The distributor that appears in the list below is located in North Carolina. You can also choose Pratiko Medical (Lyndon, Vermont).

Your Kansas retailer(Required)

The distributor that appears in the list below is located in Kansas. You can also choose Pratiko Medical (Lyndon, Vermont).

Your Colorado retailer(Required)

The distributors that appear in the list below are located in Colorado. You can also choose Pratiko Medical (Lyndon, Vermont).

Your New-York retailer(Required)

The distributors that appear in the list below are located in New York State. You can also choose Pratiko Medical (Lyndon, Vermont).

Your Pennsylvania retailer(Required)

The distributors that appear in the list below are located in Pennsylvania. You can also choose Pratiko Medical (Lyndon, Vermont).

Your Virginia retailer(Required)

The distributors that appear in the list below are located in Virginia. You can also choose Pratiko Medical (Lyndon, Vermont).

Your retailer(Required)

The state you selected does not have a local distributor. Pratiko Medical will take care of you.

Hidden

4. Determination of suitable Pratiko blocking discs

Size of your wheelchair wheels(Required)

This is the size of the rear wheels of the chair: the size is supposed to be indicated on the sidewall of the tire. If it is not, measure the height from the ground to the highest point of the tire and then round up to the nearest number (23.5" = 24").

18 inches

20 inches

22 inches

24 inches

Your personalized Pratiko blocking disc(Required)

PRA-U-CH018

Your personalized Pratiko blocking disc(Required)

PRA-U-CH020

Your personalized Pratiko blocking disc(Required)

PRA-U-CH022

Your personalized Pratiko blocking disc(Required)

PRA-U-CH024

Hidden

5. Determination of the need for a Pratiko attachment kit

The driving hoop attaches to the wheel in two ways: either by hollow piercing or by tongue ties.

Hollow piercing ties

Tongue ties

Type of hoop on your wheelchair(Required)

Your Pratiko attachment kit(Required)

PRA-U-KITLANG

With this type of driving hoop, you do not need an attachment kit(Required)

N/A

Hidden

6. Installation, comments and validation

System installation

I would like my distributor to install the system.

I want to install the system myself.

Comments and questions

CAPTCHA

1. Contact informations

2. Choice of your retailer

3. Determination of the appropriate Pratiko installation kit

4. Determination of suitable Pratiko blocking discs

5. Determination of the need for a Pratiko attachment kit

6. Installation, comments and validation