Record Express, LLC :: Order :: Document Imaging Request Form

Document Imaging Information Request

Contact Information

Company Name:

Address 1:

Address 2:

Contact Name:

Phone:

Email:

Fax:

Job Specifications

Where Would You Like to Have
Your Documents Scanned:

My Location
Record Express's Location

What Type of Documents are They:

Standard Office
Legal
Medical
Mixed

Fragile/Historic
Photographs
Aperture Cards
Books

Slides
Film
Other

Please Choose Your Color Type:

Color
Black & White
Grayscale

Mixed
Not Sure

What Resolution Would You Like:

200 dpi
300 dpi
600 dpi

1200 dpi
Not Sure

What Amount of Documents Are You Looking to Have Scanned:

Number of:

Pages
Folders
Books
Boxes
Small File Cabinets

Large File
Cabinets
Rooms
Not Sure

Would you like to apply any of the following to the imaging process:

OCR Numbering Indexing

Do the documents need any of the following preparation:

Binder Removal Staple & Paperclip Removal
Other Not Sure None

In what file format would you like to receive your scanned files:

PDF
TIFF
JPG

BMP
GIF
Other

On what media would you like to receive your scanned files:

CD
DVD
Portable Hard Drive

FTP
Not Sure

How soon would you like these documents scanned:

Immediately
Within 30 days
Within 60 days

Within 12 months
Not Sure

How would you like to be contacted:

Phone
Fax
Email

What is the best time to contact you?

AM PM