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Intake form
Help us serve you better
Name
*
Email address
*
What type of IT services are you interested in?
Please select at least one option.
Network Management
Cloud Services
Data Backup and Recovery
Cybersecurity Solutions
IT Consulting
Help Desk Support
Software Development
Hardware Procurement
What is your preferred method of contact?
Select
Email
Phone
In-Person
What is the size of your organization?
Select
1-10 Employees
11-50 Employees
51-200 Employees
201-500 Employees
500+ Employees
What is your primary industry?
Select
Healthcare
Finance
Education
Retail
Manufacturing
Technology
Non-Profit
Please describe the specific IT issues you are facing.
When do you need these services?
Select
Immediately
Within a month
Within three months
Flexible
Do you currently have an IT provider?
Select
Yes
No
How did you hear about us?
Select
Search Engine
Social Media
Referral
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Additional questions or comments
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