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Your Email Address
*
Email
Confirm Email
Technician Completing Form (if applicable)
-- MAKE SELECTION --
Csavoj, Nick - CG-E-0002
Wruck, Chris - CG-O-0000
Wruck, Sarah - CG-O-0001
Name of Person Completing Form (if not a Computer Guts Technician)
Organization/Client Name
*
Organization/Client Point of Contact Name
*
First
Last
Organization/Client Contact Number(s)
*
ex. 715-123-4567, 608-123-4567, 262-123-4567
Organization/Client Point of Contact Email Address
*
Email
Confirm Email
Service Address
*
ex. 123 Main St, Merrillan, WI 544754
Invoice/Billing Email Address
*
Email
Confirm Email
HIPAA
*
Yes
No
Are you a HIPAA covered Entity?
HIPAA - BAA
*
Yes
No
N/A - not a HIPAA entity
If you are a HIPAA covered entity, do you have a BAA (Business Associate Agreement) available? Example: https://www.hhs.gov/hipaa/for-professionals/covered-entities/sample-business-associate-agreement-provisions/index.html
Business Phone Line Count #
*
How many phones/extensions are needed?
Current Business Phone Provider
*
Who is the current phone/VoIP provider?
Employee Count #
*
How many employees? Full & Part-Time
Email Accounts #
*
How many email accounts?
Current Email Provider
*
Google Workspace
Microsoft 365
ProtonMail
Rackspace
Other (specify below)
Other Email Provider(s)
Windows Desktop/Workstation #
*
How many Windows Desktop/Workstations?
Windows Laptop #
*
How many Windows Laptops?
Linux Desktop/Workstation #
*
How many Linux Desktop/Workstations?
Linux Laptop #
*
How many Linux Laptops?
Apple/Mac Desktop/Workstation #
*
How many Mac Desktop/Workstations?
Apple/Mac Laptop #
*
How many Mac Laptops?
Workstation & Laptop Operations
*
Are there any specific devices that are not servers that must not be rebooted during business hours or may require to be left online without a reboot during non-business hours for any reason? If so, please provide details, if not, type N/A.
Servers #
*
How many servers?
Server OS
*
Windows
Linux (CentOS, Ubuntu, Etc)
OS X
Other (specify below)
Other Server OS
Server #1 Role
Describe Purpose and Specifications such as version (ex. Windows Server 2022), how much RAM, Storage, etc.
Server #2 Role
Describe Purpose and Specifications such as version (ex. Windows Server 2022), how much RAM, Storage, etc.
Server #3 Role
Describe Purpose and Specifications such as version (ex. Windows Server 2022), how much RAM, Storage, etc.
Server #4 Role
Describe Purpose and Specifications such as version (ex. Windows Server 2022), how much RAM, Storage, etc.
Firewall - Hardware #
*
How many hardware firewalls?
Firewall Vendors
*
Barracuda
Cisco
Fortinet
Juniper
Palo Alto
pfSense/Netgate
Sonic Wall
Sophos
WatchGuard
Other (specify below)
Choose all that apply.
Other Firewall Vendor(s)
Specify other Firewall Vendors not listed - separate by using a comma.
Apple iPhone #
*
How many iPhone's?
Apple iPad #
*
How many iPad's?
Android Phone #
*
How many Android Phones?
Android Tablet #
*
How many Android Tablets?
Network Printer #
*
How many network printers?
Standalone Printer #
*
How many standard printers?
Printer Brands/Vendors
*
Brother
Canon
Epson
HP
Lexmark
Ricoh
Xerox
Other (specify below)
Other Printer Brands/Vendors
Network Switch #
*
How many network switches?
Network Switch Brand/Vendor
*
Aruba
Cisco
Dell
Fortinet
HPE
Juniper
Netgear
TP-Link
WatchGuard
Other (specify below)
Other Switch Brand/Vendor(s)
Specify other Switch Vendors not listed - separate by using a comma.
Router #
*
How many routers? Include ISP provided equipment.
Router Brand/Vendor
*
Arbua
Cisco
Dell
Fortinet
HPE
Juniper
pfSense/Netgate
Watchguard
Other (specify below)
Other Router Brand/Vendor
Internet Service Provider
*
AT&T/Firstnet
Brightspeed/CenturyLink
Bug Tussel
Lynxx
Spectrum/Charter
Starlink
TCC
TDS
T-Mobile
UScellular
Verizon
Other (specify below)
Select your current Internet Service Provider(s). If not listed, please select other and list the provider(s).
Other Internet Service Provider
Surveillance Camera #
*
How many surveillance cameras?
Surveillance Camera Connection Type:
*
POE
Wireless
CCTV/Other
Select camera connection type.
Internet Speed
*
Please provide the current Internet speed you are able to obtain. If you do not know, please go to www.speedtest.net and click GO; provide the results above. Example: 250/40, where 250 is the download, and 40 is the upload speed. You can also paste the link to the speed test result provided by right-clicking the "result ID" link (at the top of the page) and going to "copy link address".
How many devices require Anti-Virus + End Point Protection/Threat Monitoring?
*
Generally you would want all devices to have this running, but depending on the configuration, there may be exceptions or a different use-case/provider.
How many devices require backup services, including servers?
*
Generally, depending on configuration, you want at minimum servers utilizing file and image backups. There may be essential workstations that would be wise to be backed up as well so important files are not lost for various reasons. Computer Guts recommends backing up all devices eligible.
Managed Services Selection
*
Access Security & Alarms
Backup and Recovery
Cybersecurity
Email Hosting
End-User/Employee IT Education/Training
General Consultation
Hardware Procurement
Help-Desk/Technical Support
Systems Monitoring
Surveillance (cameras)
Vendor Management
VoIP (phone services)
Web Hosting
Other (specify below)
Other Managed Services Selection
Please detail what type of services you would like.
Third Party IT Providers & Contracts
*
Please list current third parties involved in the management of your IT and if you are currently under contract with them. If you are under contract, please provide the end date, if possible.
Do you have existing documentation for your IT management?
*
Yes
No
Not Sure/Maybe
Roles & Permissions
*
Describe specific roles or increased permissions required in the management of your IT infrastructure. For example, does a specific employee need additional privileges to carry out their duties? Does a specific employee need access to a certain database, file storage system, etc?
Leasing & Warranties
*
Please provide any details regarding leasing/service contracts for any network equipment (workstations, laptops, servers, printers, routers, switches, etc), and any warranties available, if possible. These are leases/contracts/warranties specifically under your organization.
Additional Details or Questions?
Provide any information or questions not covered by this survey or any other details that may be pertinent to our onboarding process and our ability to provide you service.
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