I would like to order a Fujitsu ix500 document scanner and activate eRx Express Paperless  –

Your Name (*)

Delivery Address (*)

Suburb (*)

State (*) Postcode (*):

Email Address (*)

Contact Number (*)


I agree to eRx Express debiting my account $620.00 (inc. GST and freight) for the delivery of the Fujitsu ix500 document scanner. The payment will be a once off amount, debited or invoiced 30 days from the date of order.