Product NamePurchase Covers and Cushions onlineThe information below will be used to create an order confirmation. The order confirmation will be emailed to you & you will have the opportunity to review, make changes and approve the order. We may need to contact you to confirm any of the above information.Name* First Last Ship to Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Phone*Email* TableSerial Number*Located at the foot of the table on the left side of the metal frame. When placing an order we require the serial to ensure you receive the proper replacementsOrder TypeReplacement Type*You can order individual table sections or, if preferred, a full replacement table set. When ordering a full table set, we always require the serial number, even if ordering a single piece. We use the serial number to ensure that you receive the proper replacement(s). Individual Table Sections Full Table Set (please call for pricing)Indicate one of the 3 following options* Cover Only Cushion & Cover Plastic Protective CoversPlease indicate your preference:* Removable protective “slip” covers - covers will slip over top of existing covers and can be removed in the future (designed for temporary use). Permanent Custom fit protective covers (to be stapled to back of existing cushion & covers)Select Table SectionsTable Sections*See diagram, Table A and Table B for replaceable item names. Headrest - $72 Upper thoracic - $39 Lower thoracic - $68 Full thoracic - $68 Pelvic- $68 Knee break- $58 Foot extension- $39 Hands- $48Table Sections*See diagram, Table A and Table B for replaceable item names. Headrest - $145 Upper thoracic - $80 Lower thoracic - $135 Full thoracic - $135 Pelvic- $135 Knee break- $111 Foot extension- $80 Hands- $97Table Sections*See diagram, Table A and Table B for replaceable item names. Headrest - $87 Upper thoracic - $54 Lower thoracic - $83 Full thoracic - $83 Pelvic- $93 Knee break- $73 Foot extension- $54 Hands - $63Color SelectionColor*You have the option to order replacements in the same color or alternatively you can select a new color. Same Color changeNew Colors & Upholstery SelectionUpholstery Type*select an upholstery typeBurkshireSpirit MillenniumWhisperFinesseLeatherWhisper | Burkshire | Spirit MillenniumWhisper*Whisper offers a superior ultra soft leather feel with excellent tailor-ability.Color may vary depending on screen display CAMEL GRAVEL ANTELOPE CAPPUCCINO LUGGAGE CINNAMON BORDEAUX MERLOT FOREST PATINA CURELEAN NAVY ELEPHANT CHARCOAL BLACK COGNAC ESSPRESSO SANGREBurkshire*Burkshire presents a richly grained, antique-aged leather finish. The pattern combines a deep and subtle grain effect with a blend of traditional and contemporary colors.Color may vary depending on screen display Neutral Wood Violet Teal Baltic Blue Honey Strawberry Black Forest Navy Earth BurgundySpirit Millennium*Spirit Millennium, colour truly comes to life in Spirit Millennium from Naugahyde. Designed with the colors of the new generation, Spirit Millennium represents a generously rich palette of beautiful colors including new directional soft tones and pastels.Color may vary depending on screen display Adobe White Alabaster Mauve Dusty Jade Dove Sand Taupe Claret Grotto GreyStone Bisque Mocha Sangria Forest Royal Terra Cotta Espresso Burgundy Black Imperial BlueFinesse*Beautifully smooth and supple finish, greater puncture resistance and a 1/8 inch foam backing for added cushion quality.Color may vary depending on screen display. Barley Beaver Black Bordeaux Burgundy Colonial Blue Grey Hershey Navy Pine Russet Stucco TaupeLeather*Color may vary depending on screen display Raven Stonedge Maple Saddle Eiger Brunette Skinlight Saphire Blue Pomegrante Teak Drift Wood Somber Grey Pumas Meringue Shell Break Khaki Dusk Charcoal Grey Dawn Livid GreyPaymentIndicate Preferred payment* Check Credit card EFT Wire