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Free Form Back Kits

Everything needed for a custom back support, in one box.

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A person in a wheelchair with a free form back support, reaching for a coffee that a barista is handing her
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Complex Seating. Simplified.

Custom contoured backrests are easily and effectively accomplished with a Free Form Backrest Kit.

HCPCS Coded E2617 and E2609. 

 

The shell can be increased or decreased in size to accomplish even support. The width between the lateral supports, lumbar curve and upper thoracic region can all be quickly and easily fitted to the client.

 

Free Form Back Kits are an excellent solution for a scoliosis, kyphosis, weight fluctuations, and anyone who requires a custom moulded backrest.

Lower Thoracic Back Shell in a box

Lower Thoracic Back Shell

Upper Thoracic Back Shell

Free Form Seating Back Kit
Alloy 2-Ball
Alloy 2-Ball

Lower Thoracic Back Kits are available in 3 sizes.

Upper Thoracic Back Kits are now available in 5 sizes.

Lower Thoracic Back Kits
14"-20" (35cm-51cm) chair width include:

  • Free Form Shell

  • Cover (Foam or Stimulite)

  • Pair of Independent Mounts

  • 4mm Hex Key

Upper Thoracic Back Kits 
14"-20" (35cm-51cm) chair width include:

  • Free Form Shell

  • Cover (Foam or Stimulite)

  • Mounting Hardware (Centre Mount or Independent Mounts)

  • 4mm Hex Key

  • Package of 8 Alloy 2-Balls for reinforcement

  • 5 Extra shell modules for adding additional support if needed

  • Extended screws for mounting accessories

Upper Thoracic Back Kit - Reinforced
20"-24" (51cm-70cm) chair width include:

  • Free Form Shell

  • Stimulite Cover

  • 4 Independent Mounts

  • 4 mm Hex Key

  • Package of 20 Alloy 2-Balls

  • 5 Extras shell modules for adding additional support if needed

  • Extended screws for mounting accessories

Custom Seating, all in one box, now available for wheelchairs up to 24”  (61cm) wide!

 

These custom moldable back supports offer extra reinforcement and are an excellent solution for larger clients that need customized positioning. 

 

These two new Back Kits come standard with a Stimulite™ cover that provides excellent heat and moisture dissipation. The Stimulite™ cover also retains its honeycomb structure and pressure redistribution qualities, even with prolonged and high compression. 

See how quickly and efficiently a Free Form Back Kit can be fitted:

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Free Form Back with Center Mount Front View
Free Form Back with Center Mount Angle View
Free Form Kit mounted to Wheelchair

Now HCPCS coded in the USA E2617 and E2609 Custom fabricated wheelchair back or seat, any size, any mounting hardware. 

New option for Free Form Back Kits:

Stimulite + Free Form ventilation image
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Free Form Back Kit Sizing

Note: Shell width and height measurements are when shell is flat and before contouring.
If ordering based on 
wheelchair width, lateral supports are typically 4" - 6" (10cm-15cm) deep.

Lower Thoracic

FFCUST-LB01
Imperial
Metric
Fits Wheelchair Width
18 - 20"
46 - 51 cm
Back Height
16 ½"
42 cm
Back Width
27"
69 cm
FFCUST-LB02
Imperial
Metric
Fits Wheelchair Width
16 - 18"
41 - 46 cm
Back Height
14"
36 cm
Back Width
23"
58.5 cm
FFCUST-LB03
Imperial
Metric
Fits Wheelchair Width
14 - 16"
36 - 41 cm
Back Height
11 ½"
29.5 cm
Back Width
18 ¾"
47.5 cm

Upper Thoracic

FFBCUST01
Imperial
Metric
Fits Wheelchair Width
18 - 20"
46 - 51 cm
Back Height
18 ½"
47 cm
Back Width
29"
73 cm
FFBCUST02
Imperial
Metric
Fits Wheelchair Width
16 - 18"
41 - 46 cm
Back Height
16 ½"
42 cm
Back Width
26 ½"
67 cm
FFBCUST03
Imperial
Metric
Fits Wheelchair Width
14 - 16"
36 - 41 cm
Back Height
14 ½"
37 cm
Back Width
21 ½"
55 cm

Upper Thoracic - Reinforced

FFBCUST-XXL
Imperial
Metric
Fits Wheelchair Width
22 - 24"
55 - 61 cm
Back Height
21"
53 cm
Back Width
34"
87 cm
FFBCUST-XL
Imperial
Metric
Fits Wheelchair Width
20 - 22"
50 - 55 cm
Back Height
19"
48 cm
Back Width
29"
74 cm
Custom shapes and sizes are available.
Please contact us for more information. 
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