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Custom Upholstery Online form

Our Products: Wheelchair Parts > Custom Upholstery Online form

Wheelchair Custom Upholstery Form
Back Upholstery
***THERE IS NO RETURNS ON CUSTOM UPHOLSTERY***
Brand of Wheelchair
Model of Wheelchair
Serial Number of Wheelchair
Quantity of Backs
Number of Holes Per Side
From the Top of the upholstery fill out the distance between each hole per The letter in the table below below
***PLEASE DOUBLE CHECK ALL YOUR MEASUREMENTS***

	Measurements in Inches (in)
A
B
C
D
E
F
G
H

Specify Back Type -
Choose Naugahyde Color Below - or Choose Nylon Below -

Dark Blue - #67 Royal Blue - #68 Royal Blue - #60 Burgundy - #27 Mauve - #23 Red - #29 Dark Green - #59 Jade - #57 Dark Brown - #89 Black - #46 Gray - #44 Green - #59 Camel - #85 Beige - #96 Black - #48 Nutmeg - #83 White - #93
Seat Upholstery
***THERE IS NO RETURNS ON CUSTOM UPHOLSTERY***
Brand of wheelchair
Model of wheelchair
Serial Number of wheelchair
***PLEASE DOUBLE CHECK ALL MEASUREMENTS***
Quantity of Seats
Number of Holes Per Side
From the Front of the upholstery fill out the distance between each hole per The letter in the table below below

	Measurements in Inches (in)
A
B
C
D
E
F
G

Choose Naugahyde Color Below - or Choose Nylon Color Below -

Dark Blue - #67 Royal Blue - #68 Royal Blue - #60 Burgundy - #27 Mauve - #23 Red - #29 Dark Green - #59 Jade - #57 Dark Brown - #89 Black - #46 Gray - #44 Green - #59 Camel - #85 Beige - #96 Black - #48 Nutmeg - #83 White - #93
Customer Information
Full Name*

First Name Last Name
E-mail*
example@example.com
Phone Number*

Area Code Phone Number
Address*

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Please feel free to call and we will be happy to answer any questions or concerns you may have.

Fax: 218-829-9744

Toll Free: 800-328-5343

Email: customerservice@ocelco.com
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About Us

Welcome to Ocelco | Serving You Since 1974

Ocelco has long been an industry leader in delivering durable medical parts and medical equipment at low prices. Ocelco has also been a leader in innovation in the field with products such as the original Ocelco Pill crusher and the new Hand Held Pill Crusher as well a diverse line of custom wheelchairs, manual wheelchairs, parts and accessories. We carry a full line of medical privacy curtains and hospital curtain track, black out curtains work well for room darkening. Our hospital curtains come in many styles and colors to choose from. Curtain track can be mounted directly to most ceilings or suspended with our track suspension tube.

Ocelco, Inc. BBB Business Review

Company

Info

Address

Ocelco.com
1111 Industrial Park Road SW
Brainerd, MN 56401
Tel: (800) 328-5343
Fax Free: (866) 829-9744
Hours: 7-4:30 PM (CST) M-F

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