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IBEX

The New Generation Integrated Digital Imaging and Patient Care System from Spectra (UK) Ltd

ENQUIRY FORM

Please Fill in this form and click submit or if you prefer print the form and fax it to us

Title

Surname

Forename

Job Title

Address 1

Address 2

Address 3

Post Code

Name of person to contact

(if different from above)

Telephone number Fax number

Best time to contact me Best day to contact me

The information below will help us ensure compatibility of your present equipment with digital technology ( note that a limited number of older cameras are not adaptable )

Our current fundus camera is made by

The model number is

Do you currently use a digital system ? Yes No

If yes, what software do you use ?

Title
Surname
Forename
Job Title
Address 1
Address 2
Address 3
Post Code

Name of person to contact (if different from above)

Telephone number		Fax number
Best time to contact me		Best day to contact me

Our current fundus camera is made by
The model number is
Do you currently use a digital system ?	Yes No
If yes, what software do you use ?