Company Name

Address

City

State

Zip

Phone
   
Fax

Email

First Name                                   Last Name
   
Title/Position

Please describe your business.

How many locations do you have?   

Do you operate your own lab?   
Yes No

If so, please describe your lab configuration. ( Please indicate if the labs are in-store, or at a central location, whether you surface or only finish lenses at this lab, and how you order lenses from outside labs.)

Check all of the following programs that you are currently using.
Inventory             How long?     Program name   
Point-of-Sale       How long?    Program name   
Accounting          How long?     Program name   
Lab Software      How long?    Program name   

Have you had any experience with an Optical point of sale program?   
Yes No
Which one?  

What did you like about this program?

What are the features that you are looking for in a program?

How did you hear about us?          If other please explain.
The Web Vision Expo ( Las Vegas ) Friend Other Optical Yellow Pages    

Please send me a demo CD packet.

Don't send me a demo CD packet, I will download it from the website.