Disc Brake Technology
Due to precise specifications involved in the installation of disc brake components, we need detailed information on the wheelchair that is to be equipped.

Name:

Company:

Phone:

Fax:

E-Mail:

Address:

City:

State/Zip:



Type of Brake System:
Manual Variable
Para
E-Brakes
Pediatric

Chair Manufacturer:

Chair Model :

Type of Wheels:

Wheel Size :

 
Please send us this information in an email to: Customer Service or give us a call at 210-341-0008

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