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Mobile Shower Commode

Prescription Form

Date:

Purchase / Rental:

CH Representative:

Quote ID:

Supporting you to support others

1300 04 05 06

Client Details

Therapist Details

Client and Therapist details

Client Full Name :

Client Address Line 1:

Client Address Line 2:

Client Address Line 3:

Postcode :

Client Phone Number:

Client Date of Birth:

Funding Body:

Client Diagnosis :

NDIS No#/ TAC Claim No#/

DVA File No#:

Plan Manager:

Plan Dates:

Therapist Full Name:

Therapist Organisation:

Therapist Phone Number:

Therapist Email Address:

Mobile Shower Commode Prescription Form

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Height

Seat to Head

Seat to Shoulder

Seat to Foot

Hip Width

Seat to Elbow

Back to Calf

Back to Knee

Thigh Height

Weight

Diagrams

1300 04 05 06

Installation considerations

Client / Carer instructions

•

Check width of doors the Mobile Shower Commode will need to be wheeled through. Consider the

width of the Mobile Shower Commode prescribed or, if necessary, consider doorway widening.

•

If the Mobile Shower Commode is to be used over the toilet, toilet height needs to be considered

and the distance from the wall. If the Mobile Shower Commode cannot be tried over the toilet,

complete the measurement form for each location.

•

Mobile Shower Commode is not recommended to transport clients long distances. If the Mobile

Shower Commode is used outdoors, or for any other purposes as it may be damaged.

•

Demonstrate how to insert and remove rack and pan.

•

Demonstrate and observe use of brakes.

•

Demonstrate and observe transfers in and out of mobile shower commode.

•

Explain that when encountering resistance, the chair should be pulled in most cases rather than

pushed - except going into the shower.

Assessment considerations

Constraints and consideration

•

If the client is ambulant with/without assistance, it may be appropriate to precribe a ﬁxed

shower chair. This will depend on the ability of the client to safely ambulate in their bathroom

area when wet.

•

Pressure risk should be assessed, particularly if the client is in the Mobile Shower Commode

for prolonged periods of time. A special padded commode seat, with added support may be

required to reduce pain, discomfort and the risk of pressure ulcers.

•

A tilt-in-space mobile shower commode may be required if the client has reduced trunk control,

postural deformities or pressure ulcer risk.

•

It is not generally recommended that footplates are removed due to the risk of the client falling

forward out of the Mobile Shower Commode. If the footplates are removed, ensure that there are

no sharp ﬁxtures protruding from the chair that could cause an injuiry.

Maintenance considerations

•

Regular wiping of the shower commode with a mild detergent and drying thoroughly, particularly

underneath, will prolong the life of the chair.

•

Check brakes are holding ﬁrmly.

•

Backrest straps should be ﬁrm and not cracking or sagging.

•

Seat cover not damaged or cracked.

•

Wheels move freely. Check and clear any hair that has accumulated in the wheels.

•

Check welds and screws for rust and deterioration. Chair seat is still securely attached to the

frame.

•

Arms are freely moving but not loose or wobbly.

•

Footplates move as appropriate and do not catch.

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Which commode do I need?

Depth

Width

of Pan

Cistern

Depth

Cistern

Width

Overall

Height

Point of

Contact

Vertical

Point of

Contact

Horizontal

Seat

Depth

Pan

Height

Pan

Height

Front of Bowl to

Feet of Cistern

•

Depth:

•

Cistern depth:

•

Width of pan:

•

Cistern width:

•

Overall height:

•

Customised seat height:

•

Point of contact vertical:

•

Point of contact horizontal:

•

Seat depth:

•

Seat height:

•

Pan height:

Seat

width

Attendant propelled

Self propelled

Tilt-in-

space

Tilt-in-

recline

Electric

tilt-in-

Space

Electric

height

adjustable

Sliding

footplate

Swing-away

footplate

Sliding

footplate

Swing-

away

footplate

Folding

swing-

away

footplate

360mm

Not Available

CR1660-36

Not Available

CR1665-36

CR1668-36

Not Available

410mm

CR1524-41

CR1660-41

CR1660-41A

CR1661-41

CR1661-41A

CR1662-41

CR1665-41

CR1668-41

CR1669-41E

460mm

CR1524-46

CR1660-46

CR1660-46A

CR1666-46

CR1661-46

CR1661-46A

CR1662-46

CR1665-46

CR1668-46

CR1669-46E

CR1641**

510mm

CR1525-51

CR1660-51

CR1660-51A

CR1666-51

CR1661-51

CR1661-51A

CR1662-51

CR1665-51

CR1668-51

CR1669-51E

CR1665-51E

Not

Available

560mm

CR1525-56

CR1660-56

CR1666-56

CR1661-56

Not

Available

CR1665-56

CR1669-56E

CR1665-56E

610mm

CR1525-61

CR1660-61

CR1666-61

CR1661-61

CR1665-61

CR1669-61E

CR1668-61

CR1669-61E

CR1665-61E

660mm

CR1525-66

CR1660-66

CR1666-66

CR1661-66

Not

Available

Not Available

Not

Available

710mm

CR1525-71

Not Available

Not

Available

‘A‘ These models are also available in adjustable height. **This model is available with electric height adjustment

1300 04 05 06

Castors

Commode details

Castor Extensions - Front

(175mm)

Code: CR260

Castor Extensions - Front

(75mm)

Code: CR224

Castor Extensions - Rear

(175mm)

Code: CR260

Castor Extensions - Rear

(75mm)

Code: CR224

Upgrade to 24” Rear Wheels

(Only to suit Self-Propelled

Shower Commode Models)

Code: CR280-20

Brake Lever Extension

Code: CR163

Amputee Setting

Wheels set back for stability

Code: CR157

Model number :

Legrests

Neoprene Wrap to suit

Legrest Stem

Code: CR171

Legrest Extension

Code: CR152L - Left

Code: CR152R - Right

Calf Support

Code: CR295C - Left

Code: CR296C - Right

Elevating Legrest

Code: CR292 - Left

Code: CR291 - Right

Stump Support

Code: CR290 - Left

Code: CR289 - Right

Thigh Support

Code: CR194L - Left

Code: CR194R - Right

Right Side Frame Opening Modiﬁcation

Code: CRMODRSO

Left Side Opening Modiﬁcation

Code: CRMODSLSO

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Footplates

Paediatric Footplate Assembly

Code: CR293PL - Left

Code: CR293PR - Right

Footplate Extension - Left

Code: CR151L

One Piece Footplate

Code: CR179-41 - 410mm width

Code: CR179-46 - 460mm width

Code: CR179-51 - 510mm width

Code: CR179-56 - 560mm width

Code: CR179-61 - 610mm width

Code: CR179-66 - 660mm width

Code: CR179-71 - 710mm width

Patented tearsafe design

swingaway, removable and

height adjustable legrests

with ﬂip-up footplates

leaving no sharp points or

protrusions - Customised

height

Code: CRMODS

Padded Footplate Covers

Code: CR168

Footplate Extension - Right

Code: CR151R

Footplate Bridge

Code: CR324

Gel Padded Footplate

Covers

Code: CR188

Footplate Extension

- Left Dimensions W x L :

Top of Seat to Heel (mm) :

Footplate Extension

- Right Dimensions W x L :

Footplate Bridge Dimension

W x L (mm) :

Angle Adjustable Footrest

Code: CR267 - Left

Code: CR268 - Right

1300 04 05 06

Arm Supports

Lock Down Arm Kit

Code: CR146

Only suitable to top position

for armrest

Armrest height

Higher Setting

Lower Setting

Slip-on Lock Down Arm Kit

(Preferred)

Code: CR287

Urethane Waterproof

Padded Arms-Standard

Code: CR301 - Left

Code: CR301 - Right

Urethane Armrest Padded

with Side Hip Torso Panel

Code: CR343-6 - Left

Code: CR343-6 - Right

Urethane Narrow

Waterproof Padded Arms

Code: CR301N - Left

Code: CR301N - Right

Gutter Arm

Code: CR286 - Left

Code: CR286 - Right

Urethane Waterproof

Waterfall Padded Arms

Code: CR343L - Left

Code: CR343R - Right

50mm Extension

Safety Arms

Code: CR307E

Transfer Bar Safety

Arms

Code: CR307T

Custom Upholstered

Armpads

Code: CR343G

Calf Supports

Bodypoint Aeromesh Shower

Chair Calf Support 400mm

Code: CR1483-16

Bodypoint Aeromesh Shower

Chair Calf Support 460mm

Code: CR1483-18

Bodypoint Aeromesh Shower

Chair Calf Support 500mm

Code: CR1483-20

Calf Support Strap

Code: CR1480

Aeromesh Padded Calf

Panel, Velco

Code: CR1482S - Small

Code: CR1482M - Medium

Code: CR1482L - Large

Arm Supports

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Supports

Contoured Headrest

Code: CR288

Bodypoint Belt

Code: CR1441-S - Small

Code: CR1441-M - Medium

Code: CR1441-L - Large

Code: CR1441-XL - Extra Large

Narrow Contoured Headrest

Code: CR288P

Drop Down Pommel

Code: CR177

Chest Strap

Code: CR160

Pelvic Strap

Code: CR162

Padded Roll

Code: CR174

Lateral Support

Code: CR167 - Left

Code: CR166 - Right

Backrest Option - only available on selected models

Scalloped Headrest

Code: CR178

Tie on Padded Back

Code: CR145

Removable Padded Backrest

Code: CR199

Fixed Padded Back

(Hand Upholstered)

Standard Dimensions:

460x250mm

Code: CR165

Mesh Backrest

Code: CR180

Fixed Padded Back (Hand

Upholstered)

Dimensions W x H

10 Degrees Recline

(Requires Castor Extension -

Rear 175mm - for Attendant

Propelled Models)

Code: CRMODRB

Removable Padded Backrest

Dimensions W x H :

Mesh Backrest

Dimensions W x H :

Distance from

seat (mm)*

*This is from seat to bottom of lateral support

1300 04 05 06

Backrest Modiﬁcation - only available on selected models

Backrest Extension - 1 Strap

Backrest Extension - 2 Strap

Backrest Extension - 3 Strap

Code: CR274-41 to suit Juvo

410mm width shower commodes

Code: CR275-41 to suit Juvo

410mm width shower commodes

Code: CR276-41 to suit Juvo

410mm width shower commodes

Code: CR274-56 to suit Juvo

560mm width shower commodes

Code: CR275-56 to suit Juvo

560mm width shower commodes

Code: CR276-56 to suit Juvo

560mm width shower commodes

Code: CR274-46 to suit Juvo

460mm width shower commodes

Code: CR275-46 to suit Juvo

460mm width shower commodes

Code: CR276-46 to suit Juvo

460mm width shower commodes

Code: CR274-61 to suit Juvo

610mm width shower commodes

Code: CR275-61 to suit Juvo

610mm width shower commodes

Code: CR276-61 to suit Juvo

610mm width shower commodes

Code: CR274-51 to suit Juvo

510mm width shower commodes

Code: CR275-51 to suit Juvo

510mm width shower commodes

Code: CR276-51 to suit Juvo

510mm width shower commodes

Code: CR274-66 to suit Juvo

660mm width shower commodes

Code: CR275-66 to suit Juvo

660mm width shower commodes

Code: CR276-66 to suit Juvo

660mm width shower commodes

Backrest Modiﬁcation -only available on Tilt-in-Space Models

Backrest Reduction - 1 Strap

Backrest Reduction - 3 Strap

Backrest Reduction - 2 Strap

Backrest Reduction - 4 Strap

Code: CRMODRBH-1

Code: CRMODRBH-3

Code: CRMODRBH-2

Code: CRMODRBH-4

Code: CR274-46HR to suit Juvo 460mm

width Tilt in Space Shower Commode

Code: CR274-61HR to suit Juvo

610mm width Tilt in Space Shower

Commode

Code: CR274-51HR to suit Juvo 510mm

width Tilt in Space Shower Commode

Code: CR274-66HR to suit Juvo

660mm width Tilt in Space Shower

Commode

Code: CR274-56HR to suit Juvo 560mm

width Tilt in Space Shower Commode

Wheelchair Backrest 1 Strap with Headrest Socket

(Headrest sold separately)

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