Site Assessment (classic)

Site Assessment
Who is filling out this form?
Business
Business Name
Main Contact name
Business Email
example@example.com
Business Phone
Please enter a valid phone number.Format: (000) 000-0000.
Address of Delivery*

Delivery Address

Street Address Line 2

CityState

Zip Code
Hours of Operation
Unavailable Delivery Days
Who should we schedule delivery with?
Who will let us in the building?
Alternate Contact Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Alternate Contact Email
Environment
YesNo
YesNo
01-55+
Parking and Environment information
Please include any on-site details such as street parking, best point of entry, or certificate of insurance required.
Power and Network

MANDATORY BEFORE DELIVERY CAN BE SCHEDULED
Your Current Power Outlet(s) (choose all that apply)
Available network/ethernet port?
copier(s) must have an ethernet connection unless it is wifi/USB capable.
Device
PCMACChromebookPhone/Tablet
Number of devices that will be used to print
YesNo
Scan to folderScan to emailAnalog (not internet) FaxingUser Authentication/Department IDsNone of the Above
YesNo
How many devices are we removing?
YesYes - And it is the Main ContactYes - And it is the Alt ContactNo
IT
IT Contact Name:
IT Provider is:
IT Contact Email:
IT Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
OnsiteOffsite3rd Party
Yes - They are freely availableYes - But only by appointmentNo - They are not available to helpNo - They will no longer be in contract
YesNo
YesNoMy IT will be able to provide answers
Scheduling below will arrange a short call with our free specialist to set up your device prior to install.
Schedule here:
Networking
Answering NO to the question above will allow you to schedule a short call with our free specialist to gather the info in the following section(s).
YesNo
Please list the desired IP address(s) and locations for the new device(s) below. Click "Save Entry" for each row:
Subnet
Gateway
DNS 1
DNS 2
Device Address Book
Yes (by listing emails)Yes (by uploading file)NoI wish to add the address book myself after installation
For help exporting your address book and other questions, please schedule here:
Upload your address book here (excel file, text file, or word document):

Cancelof
Please list the names and emails for the users you want added to the address book here. Click "Save Entry" for each row:
Scan to Email
SMTP Server Address
SMTP "From" Address
25465587Other
SSLTLSSSL/TLSSSL Off
IMPORTANT:
If your SMTP has a password, please have it ready and available on the day of delivery for our installers.
Notes
Enter any additional notes or comments here:
DO NOT TOUCH
Should be Empty:

Site Assessment

Business

Environment

Power and Network

Device

IT

Networking

Device Address Book

Scan to Email

Notes