Complete Xerox Document Solutions

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In order for us to best meet your needs, we need to know more about you. Please fill out the form below with as much information as possible. Your Account Manager will contact you to schedule your Office Consultation within one business day. Any requests entered after 5pm EST should allow one additional day for request to process. Thank you for your participation. We look forward to working with you soon!

*Required Fields

Contact Information

Company

*First Name

*Last Name

Phone Number

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*Email Address

Web Site Address

I am interested in:

Office Equipment

	Printer
	Copier
	Color
	SOLID INK (Eco-Friendly Color Printer)
	Fax
	Scanning
	Scan to Email
	Networked
	Production Equipment
	Color Digital Press
	Wide Format
	High Volume B/W

Software

	Color Management Software
	Digital Archive
	Document Edit/Distribution
	Document Management
	Industry Specific Software
	Print Management
	Variable Data Software

Other

I currently have:

Equipment 1 Brand

Model 1

Description 1

Equipment 2 Brand

Model 2

Description 2

Equipment 3 Brand

Model 3

Description 3

Other

I print/copy approximately _____ black/white pages per month

(enter amount)

I print/copy approximately _____ color pages per month

(enter amount)

Current problem(s)
(Mark all that apply)

	I WANT TO GO GREEN!
	Service
	Equipment Reliability
	Equipment Outdated
	Business Needs Change/Expand
	Quality
	Speed
	Productivity
	Other

Additional questions/comments