Evaluation Form

If you do not know all the answers and seek advice from V-viz please feel free to enter as much information you have in your description and we will contact you to discuss further.

First name:


Last name:


Job Title:


Company:


Address:


Address 2:


City:


County:


Postcode:


Country:


Work phone:


Mobile:


Email:


Please describe the application and what is being imaged:


What are the dimensions of your Field of View (X and Y axis)?:


What is the background?:


Can the part be backlit:
Yes    No

How close can the light be mounted to the part?:


Lens type used:


What is the lens to part distance:


Is this a continuous illumination or strobed application:
Please choose one... Continous Strobed

Colour or B&W camera?:
Please choose one... Colour B&W

Vision system provider:
Acuity CiMatrix Banner Cognex Coreco DVT Integral Vision Keyence Matrox National Instrument NeuroCheck Omron PPT Sharp Siemens Other

Any environmental factors (oil, heat, moisture, etc.):
Yes    No
If yes - briefly describe:


Can you provide samples for us to image?:
Yes    No

Do you need them returned?:
Yes    No

May we use images of your part for training and marketing purposes?:
Yes    No

How many systems require lighting?:


What is your anticipated install date?:


Additonal application comments:


How did you hear of V-viz:
Please choose one... Distributor Web Search Trade Show Publication