First Name
Last Name
Phone Number
*
Email
*
Your Title & Are you One of the Decision Makers
*
Organization Name
*
Address
Street Address
City
State
Country
Country
Postal code
Current IT Consultant?
What is a line of business/Industry?
*
Are you a Non-profit or For-profit organization?
*
Non-Profit
For-Profit
What's your Company's Annual Revenue?
*
Annual Revenue
What Services your Company is Looking for?
*
Select Services
How many employees use computers?
Please List the Hardware Count for your Company
*
Total Laptops
Total Desktops
Total Physical Servers
Total Virtual Servers
Do you have Admin access to your systems?
*
Do you have a diagram of your Network?
*
Yes
No
Do you have a Firewall on your Network? if yes, list brand and model
Is your network monitored?
*
Do you have any industry compliance requirements?
*
PCI
HIPAA
NIST
CIS
BSA
Other
None
Do you perform yearly compliance audits for your Business?
*
Yes
No
No, I need to
What type of work do you do with your computers
General Office Work
Financials
Inventory Management
Email
CAD/CAM
Graphic Design
Manufacturing
Dev
Who takes care of your current IT needs ?
In-House IT support
Outsourced IT support
Ad Hoc / Breakfix
None
What are the computer programs (by name and function) that are most critical to your daily operations?
*
Will you be adding any new business programs in the near future?
*
Growth forecast
Do you foresee any change(s) in the number of people that use PCs over the next months/year?
*
No Change
Slow Growth
Exponential Growth
Other
Who is your current Internet service provider (ISP)?
*
Is your office connected to any other sites via VPN?
Yes
No, But we would like to
No, We don't need to
Who's your Email Provider?
Google Workplace
Office 365
Not sure
Other
Do you use any spam filtering services?
*
Yes
No
Is sensitive information transferred to external recipients? If so, are controls in place to protect sensitive information when transferred (e.g. with encryption)?
*
Yes
No
Not sure
How often do you perform periodic vulnerability scans on your IT systems, networks and supporting security systems? i.e. Internal assessments, third party assessments, automated?
*
Are systems and networks monitored for security events? If so, please describe this monitoring. i.e. server and networking equipment logs monitored regularly. Servers, routers, switches, wireless AP's. Also What tools do you use to do so?
Do you have a process to review user accounts and related access?
Yes
No
Not sure
Are duties separated, where appropriate, to reduce the opportunity for unauthorized modification, unintentional modification or misuse of the organization's IT assets?
Yes
No
Not sure
Do you currently have a Backup and Disaster Recovery Solution (BCDR)?
*
Yes
No
Not sure
Do you have cybersecurity Insurance?
*
Yes
No
We don't need it
If you have Cybersecurity insurance, Does your Insurance require a yearly vulnerability assessment for your network?
*
Yes
No
Not sure
If you could improve one thing about your IT situation, what would it be?
*
How can we assist you with your IT challenges?
*
Any special IT projects you need help with?
*
How much are you currently spending on IT per month (just a rough estimate)
*
