• "SCAN Type (period / intervals of use)" is a required field.
  • "First name:" is a required field.
  • "Last name:" is a required field.
  • "SCAN contact email:" is a required field.
  • "Terms of use" is a required field.



  • SCAN Order Form

    Please enter your order details below.  Fields with a red * beside them are mandatory.

    If you have any questions contact Cognitive Edge.

    The generic text for all our SCAN products is provided as a sample below.  Please edit for your particular SCAN initiative.  

    If you need help with this, please be in touch via the contact link on the relevant SCAN page.



    Can be changed with advance notice.

    • 0 USD

    You can purchase up to three (3) additional months of SCAN use.


    • 0 USD added to order total

    Default language is English. Note that additional charges will apply to additional language requests.  Cognitive Edge will contact you with price details based on your request.


    This is the one question that you can customize for your SCAN setup.  We recommend you keep your question to less than 10 words. 


    Please limit your answer list to less than 12 answers.  We recommend you include "Prefer not to say" and "Other" as answer options.  A free text option for "Other" is not offered with standard SCANs.

    An example answer list: USA, Canada, Mexico, Brazil, Chile, Colombia, Other, Prefer not to say

    • (max file size 128 MB)

    Max. file size 1MB

    SCAN Contact person:

    Please provide the name of the person our support team should coordinate SCAN details with.

    Order total: