RENEGADE LP (RS6)

The lowest profile vertical shock foot Less than 5 of clearance required for most commonly used sizes. Utilizes the same patented Z-Shock Technology as the standard Renegade (RS 1000) Less than 1/3 the weight of alternative shock foot products All-carbon z-shaped heel is the most durable shock design available Carbon fiber lay-ups are engineered to deliver a smooth gait at any speed, resulting in a comfortable walking foot that can stand up to high-activity forces Incorporates full-length sole plate, creating natural inversion-eversion Designed for K3/4 amputees Rated up to 365 lbs

Size*: 22-30 cm

*Special Order Size 31 cm (7-10 day lead time)

Clearance & Weight:

Size 22-25 cm 26-28 cm 29-31 cm Clearance 4.4 in 4.8 in 5.2 in Avg. Weights Foot Shell 337g 403g 496g 127g 159g 219g
User Weight Rating: 365 lbs Stiffness Category: 1-9 Heel Height: 3/8 Connector: Integral male pyramid Warranty: 36 months
Note: A Spectra sock and pyramid connector are included with purchase.

REQUIRED ACCESSORIES

Cosmetic Foot Shell:
High-profile (Default) FTC-2H Mid-profile (Optional) FTC-2M Choice of caucasian or ebony skin tone

OPTIONAL ACCESSORIES

Replacement Renegade Sole Plate- Part #RS6-SP Foot Shell Removal Tool- Part #ACC-00-103 Additional Spectra Sock- Part #ACC-00-101xx (12, 14, 18) Additional Stiffening BumpersKIT-00-Durometer, Sizes 22-25cm KIT-00-Durometer, Sizes 26-28cm KIT-00-Durometer, Sizes 29-31cm

Freedom Innovations, LLC

30 Fairbanks, Ste. 114, Irvine, CA 92618

Order Form - USA

www.freedom-innovations.com
(888) 818-6777 (949) 672-0032 Fax (949) 672-0084
Ground 2nd Day Next Day Early AM
Order Date: Ordered By: Special Order Notes:

Req. Ship Date: PO #:

Ship Via: Ship Notes:

BILL TO:

Name Address City State Zip Phone ( )

SHIP TO:

Note: If Warranty or 60 Day Return Re-Order, please call Customer Service prior to ordering. Patient Data Name / ID#: Foot Size (cm): Amputation: Module Needed: Skin Tone:

Beige Left Right Left

Age: Weight (lbs):

Bilateral Right Both

Gender:

Ft in Hip Disartic - HD

Height: Level:
Transtibial - BK Transfemoral - AK

Knee Disartic - KD

Patient Notes:
Low Activity (K2 or K3) Typical daily living, walking, golf, bicycling Moderate Activity (K3) Repetitive activities, recreational sports, jogging, dancing High Activity (K3 to K4) Rigorous activities, competitive sports, running, power lifting, snowboarding Clearance Measurement (inches): (From most distal aspect of socket to the ground Include space for a liner, shuttle lock, etc.) RETURNS, ADJUSTMENTS, CREDITS
We are committed to the complete satisfaction of the prosthetist and amputee. We deliver most products with a 60 day Satisfaction Guarantee. If you are dissatisfied with a Freedom standard production product for any reason, you may return it for a full refund within 60 days of the original invoice date. Modular components and liners can be returned within 60 days of purchase only if their packaging is unopened. All returns require a Return Authorization Number (RA#), which is obtained by calling Freedom Innovations Customer Service or the Distributor through which the product was originally ordered. No returns will be accepted without an RA #. A restocking fee of 20% may be applied to orders returned after the 60 day Satisfaction Guarantee.

Internal Use MF Rep:

CS Rep: Notes:

Order #:

F-720-026 FI Product Order Form, External, Rev. J
PRODUCT SELECTION- Page 2
(Please complete appropriate data fields for your selection.)

Renegade

Renegade LP

Runway

Silhouette

Silhouette LP

Slalom Ski
Renegade (RS1) Renegade LP (RS6)
Sizes (22-30 cm) Stiffness Category (1-9) Foot Shell Height
Runway (RS2) (Push button adjustable) Runway HX (RS2-K1) (Hex key adjustable)
Sizes (22-28 cm) Stiffness Category (1-6)

Mid-profile

(RS1 Default)

High-profile

(RS6 Default)

No Shell

Foot Shell Style

Standard

Sandal Toe
Optional Pre-Cut Shin Foam Special Order Size 31 cm (7-10 day lead time) Renegade SX (RS1-S1) Single-Axis Rotation Renegade LP-SX (RS6-S1)
Sizes (22-30 cm) Stiffness Category (1-6) Foot Shell Height SX
Silhouette (RS4) w/34mm female tube clamp Silhouette LP (RS5) w/male pyramid adapter

(Default)

(RS1-S1 Default)

(RS6-S1 Default)

Special Order Size 31 cm (7-10 day lead time) Renegade MX (RS1-M1) Multi-Axial Rotation Renegade LP-MX (RS6-M1)
Sizes (22-30 cm) Stiffness Category (1-7) Foot Shell Height MX
Special Order Size 31 cm (7-10 day lead time) 30 mm knee pyramid adapter Versa Clamp

CUSTOM PRODUCTS

Nitro Running Foot (7-10 day lead time)

User Weight (lbs.)

Tall Profile (9.5) Short Profile (7.5)

(FS6) (FS9)

(RS1-M1 Default)

(RS6-M1 Default)

Slalom (SKI) (7-10 day lead time)

Length of Sound Side Ski Boot in cm OR Length of Ski Binding in cm User Weight (lbs.)
Special Order Size 31 cm (7-10 day lead time)
Freestyle Swim Foot (SW2) (24 hour lead time)
Sizes (22-30 cm) Stiffness Category (1-6)
Mid-profile No Shell Special Order Size 31 cm (7-10 day lead time)

Foot Shell Height

PRODUCT SELECTION- Page 3

Sierra

Highlander

Pacifica

Pacifica LP

LP Symes

Defender

Senator

Sierra (FS1)

LP Symes (LP2)

Sizes (22-30 cm) Stiffness Category (1-9)
Optional Pre-Cut Shin Foam Special Order Size 31 cm (7-10 day lead time)
Defender (FS3) Highlander (FS3)
Sizes (22-30 cm) Stiffness Category (1-9) Foot Shell Height Sizes (16-21 cm) Stiffness Category (1-6P-1A) Foot Shell

Pediatric Shell No Shell

Senator (VS1) (Includes Mid Profile Shell)
Highlander Max Foot, rated to 500lbs (7-10 day lead time) HD 34mm Component Kit for users weighing up to 500 pounds Special Order Size 31 cm (7-10 day lead time) Exoskeletal Configuration

Pacifica (FS2)

Sizes (24-30 cm) Stiffness Category (1-9) Foot Shell Height

Parydonn Liner

Determine liner size by taking a circumferential measurement, at normal pressure, 4cm from the distal end of the residual limb. If the exact measurement size is not available, defer to the next size down. Choosing a liner size larger than the measurement taken is not recommended.
Locking Liner, 3 mm Cushion Liner, 3 mm
Quantity Size (Check Box)

Pacifica LP (FS4)

22cm 28cm

23.5cm 30cm

25cm 32cm

26.5cm 34cm

Components/Adapters

Part #

Description

Quantity

PRODUCT INFORMATION- Page 4
Product Clearance & Weight Chart Product Size Sierra (FS1) Highlander (FS3) Pacifica (FS2) Pacifica LP (FS4) Renegade (RS1) Renegade LP (RS6) Renegade SX (RS1-S1) Renegade LP-SX (RS6-S1) Renegade MX (RS1-M1) Renegade LP-MX (RS6-M1) Runway/HX (RS2 / RS2K1) Standard Shell Runway/HX (RS2 / RS2K1) Sandal Toe Shell Silhouette (RS4) Silhouette LP (RS5) LP Symes (LP2) Senator (VS1) Defender (FS3) 22-25 cm 26-28 cm 29-31 cm 22-25 cm 26-28 cm 29-31 cm 24-25 cm 26-28 cm 29-31 cm 22-25 cm 26-28 cm 29-31 cm 22-25 cm 26-28 cm 29-31 cm 22-25 cm 26-28 cm 29-31 cm 22-25 cm 26-28 cm 29-30 cm 22-25 cm 26-28 cm 29-30 cm 22-25 cm 26-28 cm 29-30 cm 22-25 cm 26-28 cm 29-30 cm 22-25 cm 26-28 cm 22-25 cm 26-28 cm 22-25 cm 26-28 cm 29-31 cm 22-25 cm 26-28 cm 29-31 cm 22-25 cm 26-28 cm 29-31 cm 22-25 cm 26-28 cm 29-30 cm 16-18 cm 19-21 cm

Clearance 5.2 in. 6.0 in. 6.7 in. 3.7 in 4.2 in 4.7 in 2.1 in 2.2 in 2.4 in 1.8 in 2.0 in 2.2 in 5.8 in 6.6 in 7.3 in 4.4 in 4.8 in 5.2 in 8.4 in 8.5 in 8.6 in 6.8 in 6.9 in 7 in 7.2 in 7.25 in 7.4 in 5.6 in 5.65 in 5.7 in 3.0 in 3.25 in 3.0 in 3.25 in 7.2 in 7.7 in 8.1 in 6.8 in 7.3 in 7.7 in 1.7 in 1.9 in 2.1 in 4.5 in 5.0 in 5.4 in 2.4 in 3.0 in
Avg. Weights Foot Shell 343g 404g 493g 310g 371g 461g 259g 310g 382g 305g 370g 435g 358g 437g 549g 337g 403g 496g 765g 836g 907g 632g 725g 794g 672g 742g 794g 553g 646g 717g 305g 355g 305g 355g 423g 453g 483g 357g 387g 417g 227g 295g 363g 362g 390g 418g 92g 107g 127g 159g 219g 127g 159g 219g 127g 159g 219g 127g 159g 219g 127g 159g 219g 127g 159g 219g 127g 159g 219g 127g 159g 219g 127g 159g 219g 127g 159g 219g 157g 223g 127g 223g 127g 159g 219g 127g 159g 219g 127g 159g 219g 127g 159g 219g 80g 121g