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Script Capture
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About
Script Capture Trial
Elie Awad
2021-01-05T10:09:16+11:00
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Pharmacy Details
Pharmacy Name
*
Your Chemist POS Customer Number
Contact Person
*
Phone Number
Email
*
Your Dispense Software
*
Fred Dispense
Fred Next
Lots
Minfos
Aquarius
Z Software
Address
*
Address Line 1
City
State / Province / Region
Postal Code
ScriptCapture Details
Number of scripts processed per day (Average)
*
Nominate the Workstation (S) for ScriptCapture
*
Email address to use with ScriptCapture
*
Already have a scanner?
*
Brother ADS-2800
Fujitsu ScanSnap iX1500
Fujitsu ScanSnap iX500
Send me a Scanner
Other (Support team to check compatibility)
Check the box of the model we currently support, If you have a model other than the ones listed then chose other and enter your model details, chose "send me a scanner" if you don't have any of these models. Freight to your area is included in the trial. The scanner will be invoiced on completion of the 30-day trial if you proceed with the service. Should you wish to cancel, please send the scanner back in its original packaging to the CPD warehouse.
Enter your Scanner Model details
This is required when you pick other for scanner
Terms & Conditions
*
I have read and agree to the
Terms of Service
This service will auto-renew after the 30 day trial unless cancelled prior to the end of your monthly trial.
Signee Name
*
Date
*
Signature
*
Clear Signature
Comment
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