Client Portal: Enhabit Site Survey

Office Information
Address*
Street Address Suite/Bldg. City State / Province / Region ZIP / Postal Code
Office Phone*

Your Current Devices
Please provide the details for all of the copiers, printers and fax machines in your office today.
How many total devices exist in your office (all copiers, printers and fax-machines)?*
Please list the make and model of ALL of your current copier(s) and printer(s) at your location on separate rows by area below.*
(Example: Copier A Home Health, Copier B Hospice)
Do you have an active phone line plugged into your existing fax machine/copier today?*
Please upload a picture of each copier and printer you have.
Drop files here or

Max. file size: 256 MB.

Your New Device Requirements
Please let us know what requirements you have for the devices in your office below.
Paper Sizes You Use*
Please check each that apply to your office needs.
- Letter (8.5 x 11)
- Legal (8.5 x 14)
- Ledger - Wide Format (11 x 17)
Please describe your 11x17 jobs?*
These paper sizes are depicted below:
Do you need for the device to staple?*
- Yes
- No
Do you use a traditional fax line to send and receive faxes or do you scan to email or use e-fax today?*
Do you currently print any documents in color?*
Do you outsource your color printing to a copy/print shop or print it in-house today?*

Contact Information