Client Information
Company Name
Office Number
Please enter a valid phone number.
Primary Contact
First NameLast Name
Primary Contact Number
Please enter a valid phone number.
Primary Contact E-mail
example@example.com
Is the Billing Contact the same as the Primary Contact?
YesNo
Billing Contact
First NameLast Name
Billing Contact Phone Number
Please enter a valid phone number.
Billing Contact E-mail
example@example.com
Physical Address
Street Address
Street Address Line 2
CityState / Province
Postal / Zip Code
Is the billing address the same as the physical address?
YesNo
Billing Address (if different than physical address)
Street Address
Street Address Line 2
CityState / Province
Postal / Zip Code

Site Information Executive Summary
Total # of Servers
Total # of Workstations
Total # of Laptops
Total # of Switches
Total Wireless Ap
24 Hour Support
General Site Notes

Extended Contact Information
Office Manager Name
First NameLast Name
Office Manager Cell
Please enter a valid phone number.
Billing/Finance Manager Name
First NameLast Name
Billing/Finance Manager Cell
Please enter a valid phone number.
Back Line Number
Please enter a valid phone number.
Alt. Fax
Please enter a valid phone number.
Main Fax
Please enter a valid phone number.

Business Hours of Operation
OPEN - CLOSE
LUNCH BREAK
Notes and Exceptions to Hours of Operation

Employee Roster
# of Employees

Configurations
Internet Configurations
ISP (Internet Service Provider)
Connection Type
Upstream (MB)
Downstream (MB)
WAN Router Configurations
Router Make/Model
Serial Number
Number of Ports
Port Types
101001000
Failover
IP Type
LAN Network Configurations (Switches)
Switches
Additional Configuration Notes
Domain and E-mail Configurations
Primary Domain Name
Secure
YesNo
Credentials
UsernamePassword
Secondary Domain Name
Secure
YesNo
Credentials
UsernamePassword
Domain Host
E-mail Host
ExchISP
Network Notes

Printer and Peripherals
How many printers?
How many scanners?

Line of Business Software Applications
Line of Business
Please list all major applications your company uses:

1. Workstation Configuration
PC Name
i.e., Operatory 1, Front Desk 2, Check-Out, Dr PC, etc.
Serial Number/Service Tag #
Warranty Date (if known)
MonthDayYear
Date
PC Make and Model
MakeModel
CPU Speed
Number of Cores
Is the PC connected to a UPS (Uninterrupted Power Supply)?
YesNo
Installed RAM
i.e., 8GB, 16GB
Type of Device
Operating System
Version
Microsoft Office
YesNo
Version
Type
Srv Pack
Additional Notes:
If you do not have any additional workstations to add, continue through the next pages and STOP at LOB Applications to continue filling out this survey.

2. Workstation Configuration
PC Name
i.e., Operatory 1, Front Desk 2, Check-Out, Dr PC, etc.
Serial Number/Service Tag #
Warranty Date (if known)
MonthDayYear
Date
PC Make and Model
MakeModel
CPU Speed
Number of Cores
Is the PC connected to a UPS (Uninterrupted Power Supply)?
YesNo
Installed RAM
i.e., 8GB, 16GB
Type of Device
Operating System
Version
Microsoft Office
YesNo
Version
Type
Srv Pack
Additional Notes:
Do you need to add another workstation?
YesNo
If you do not have any additional workstations to add, continue through the next pages and STOP at LOB Applications to continue filling out this survey.

3. Workstation Configuration
PC Name
i.e., Operatory 1, Front Desk 2, Check-Out, Dr PC, etc.
Serial Number/Service Tag #
Warranty Date (if known)
MonthDayYear
Date
PC Make and Model
MakeModel
CPU Speed
Number of Cores
Is the PC connected to a UPS (Uninterrupted Power Supply)?
YesNo
Installed RAM
i.e., 8GB, 16GB
Type of Device
Operating System
Version
Microsoft Office
YesNo
Version
Type
Srv Pack
Additional Notes:
Do you need to add another workstation?
YesNo
If you do not have any additional workstations to add, continue through the next pages and STOP at LOB Applications to continue filling out this survey.

4. Workstation Configuration
PC Name
i.e., Operatory 1, Front Desk 2, Check-Out, Dr PC, etc.
Serial Number/Service Tag #
Warranty Date (if known)
MonthDayYear
Date
PC Make and Model
MakeModel
CPU Speed
Number of Cores
Is the PC connected to a UPS (Uninterrupted Power Supply)?
YesNo
Installed RAM
i.e., 8GB, 16GB
Type of Device
Operating System
Version
Microsoft Office
YesNo
Version
Type
Srv Pack
Additional Notes:
Do you need to add another workstation?
YesNo
If you do not have any additional workstations to add, continue through the next pages and STOP at LOB Applications to continue filling out this survey.

5. Workstation Configuration
PC Name
i.e., Operatory 1, Front Desk 2, Check-Out, Dr PC, etc.
Serial Number/Service Tag #
Warranty Date (if known)
MonthDayYear
Date
PC Make and Model
MakeModel
CPU Speed
Number of Cores
Is the PC connected to a UPS (Uninterrupted Power Supply)?
YesNo
Installed RAM
i.e., 8GB, 16GB
Type of Device
Operating System
Version
Microsoft Office
YesNo
Version
Type
Srv Pack
Additional Notes:
Do you need to add another workstation?
YesNo
If you do not have any additional workstations to add, continue through the next pages and STOP at LOB Applications to continue filling out this survey.

6. Workstation Configuration
PC Name
i.e., Operatory 1, Front Desk 2, Check-Out, Dr PC, etc.
Serial Number/Service Tag #
Warranty Date (if known)
MonthDayYear
Date
PC Make and Model
MakeModel
CPU Speed
Number of Cores
Is the PC connected to a UPS (Uninterrupted Power Supply)?
YesNo
Installed RAM
i.e., 8GB, 16GB
Type of Device
Operating System
Version
Microsoft Office
YesNo
Version
Type
Srv Pack
Additional Notes:
Do you need to add another workstation?
YesNo
If you do not have any additional workstations to add, continue through the next pages and STOP at LOB Applications to continue filling out this survey.

7. Workstation Configuration
PC Name
i.e., Operatory 1, Front Desk 2, Check-Out, Dr PC, etc.
Serial Number/Service Tag #
Warranty Date (if known)
MonthDayYear
Date
PC Make and Model
MakeModel
CPU Speed
Number of Cores
Is the PC connected to a UPS (Uninterrupted Power Supply)?
YesNo
Installed RAM
i.e., 8GB, 16GB
Type of Device
Operating System
Version
Microsoft Office
YesNo
Version
Type
Srv Pack
Additional Notes:
Do you need to add another workstation?
YesNo
If you do not have any additional workstations to add, continue through the next pages and STOP at LOB Applications to continue filling out this survey.

8. Workstation Configuration
PC Name
i.e., Operatory 1, Front Desk 2, Check-Out, Dr PC, etc.
Serial Number/Service Tag #
Warranty Date (if known)
MonthDayYear
Date
PC Make and Model
MakeModel
CPU Speed
Number of Cores
Is the PC connected to a UPS (Uninterrupted Power Supply)?
YesNo
Installed RAM
i.e., 8GB, 16GB
Type of Device
Operating System
Version
Microsoft Office
YesNo
Version
Type
Srv Pack
Additional Notes:
Do you need to add another workstation?
YesNo
If you do not have any additional workstations to add, continue through the next pages and STOP at LOB Applications to continue filling out this survey.

9. Workstation Configuration
PC Name
i.e., Operatory 1, Front Desk 2, Check-Out, Dr PC, etc.
Serial Number/Service Tag #
Warranty Date (if known)
MonthDayYear
Date
PC Make and Model
MakeModel
CPU Speed
Number of Cores
Is the PC connected to a UPS (Uninterrupted Power Supply)?
YesNo
Installed RAM
i.e., 8GB, 16GB
Type of Device
Operating System
Version
Microsoft Office
YesNo
Version
Type
Srv Pack
Additional Notes:
Do you need to add another workstation?
YesNo
If you do not have any additional workstations to add, continue through the next pages and STOP at LOB Applications to continue filling out this survey.

10. Workstation Configuration
PC Name
i.e., Operatory 1, Front Desk 2, Check-Out, Dr PC, etc.
Serial Number/Service Tag #
Warranty Date (if applicable)
MonthDayYear
Date
PC Make and Model
MakeModel
CPU Speed
Number of Cores
Is the PC connected to a UPS (Uninterrupted Power Supply)?
YesNo
Installed RAM
i.e., 8GB, 16GB
Type of Device
Operating System
Version
Microsoft Office
YesNo
Version
Type
Srv Pack
Additional Notes:
Do you need to add another workstation?
YesNo
If you do not have any additional workstations to add, continue through the next pages and STOP at LOB Applications to continue filling out this survey.

11. Workstation Configuration
PC Name
i.e., Operatory 1, Front Desk 2, Check-Out, Dr PC, etc.
Serial Number/Service Tag #
Warranty Date (if known)
MonthDayYear
Date
PC Make and Model
MakeModel
CPU Speed
Number of Cores
Is the PC connected to a UPS (Uninterrupted Power Supply)?
YesNo
Installed RAM
i.e., 8GB, 16GB
Type of Device
Operating System
Version
Microsoft Office
YesNo
Version
Type
Srv Pack
Additional Notes:
Do you need to add another workstation?
YesNo
If you do not have any additional workstations to add, continue through the next pages and STOP at LOB Applications to continue filling out this survey.

12. Workstation Configuration
PC Name
i.e., Operatory 1, Front Desk 2, Check-Out, Dr PC, etc.
Serial Number/Service Tag #
Warranty Date (if known)
MonthDayYear
Date
PC Make and Model
MakeModel
CPU Speed
Number of Cores
Is the PC connected to a UPS (Uninterrupted Power Supply)?
YesNo
Installed RAM
i.e., 8GB, 16GB
Type of Device
Operating System
Version
Microsoft Office
YesNo
Version
Type
Srv Pack
Additional Notes:
Do you need to add another workstation?
YesNo
If you do not have any additional workstations to add, continue through the next pages and STOP at LOB Applications to continue filling out this survey.

13. Workstation Configuration
PC Name
i.e., Operatory 1, Front Desk 2, Check-Out, Dr PC, etc.
Serial Number/Service Tag #
Warranty Date (if known)
MonthDayYear
Date
PC Make and Model
MakeModel
CPU Speed
Number of Cores
Is the PC connected to a UPS (Uninterrupted Power Supply)?
YesNo
Installed RAM
i.e., 8GB, 16GB
Type of Device
Operating System
Version
Microsoft Office
YesNo
Version
Type
Srv Pack
Additional Notes:
Do you need to add another workstation?
YesNo
If you do not have any additional workstations to add, continue through the next pages and STOP at LOB Applications to continue filling out this survey.

14. Workstation Configuration
PC Name
i.e., Operatory 1, Front Desk 2, Check-Out, Dr PC, etc.
Serial Number/Service Tag #
Warranty Date (if known)
MonthDayYear
Date
PC Make and Model
MakeModel
CPU Speed
Number of Cores
Is the PC connected to a UPS (Uninterrupted Power Supply)?
YesNo
Installed RAM
i.e., 8GB, 16GB
Type of Device
Operating System
Version
Microsoft Office
YesNo
Version
Type
Srv Pack
Additional Notes:
Do you need to add another workstation?
YesNo
If you do not have any additional workstations to add, continue through the next pages and STOP at LOB Applications to continue filling out this survey.

15. Workstation Configuration
PC Name
i.e., Operatory 1, Front Desk 2, Check-Out, Dr PC, etc.
Serial Number/Service Tag #
Warranty Date (if known)
MonthDayYear
Date
PC Make and Model
MakeModel
CPU Speed
Number of Cores
Is the PC connected to a UPS (Uninterrupted Power Supply)?
YesNo
Installed RAM
i.e., 8GB, 16GB
Type of Device
Operating System
Version
Microsoft Office
YesNo
Version
Type
Srv Pack
Additional Notes:
Do you need to add another workstation?
YesNo
If you do not have any additional workstations to add, continue through the next pages and STOP at LOB Applications to continue filling out this survey.

16. Workstation Configuration
PC Name
i.e., Operatory 1, Front Desk 2, Check-Out, Dr PC, etc.
Serial Number/Service Tag #
Warranty Date (if known)
MonthDayYear
Date
PC Make and Model
MakeModel
CPU Speed
Number of Cores
Is the PC connected to a UPS (Uninterrupted Power Supply)?
YesNo
Installed RAM
i.e., 8GB, 16GB
Type of Device
Operating System
Version
Microsoft Office
YesNo
Version
Type
Srv Pack
Additional Notes:
Do you need to add another workstation?
YesNo
If you do not have any additional workstations to add, continue through the next pages and STOP at LOB Applications to continue filling out this survey.

17. Workstation Configuration
PC Name
i.e., Operatory 1, Front Desk 2, Check-Out, Dr PC, etc.
Serial Number/Service Tag #
Warranty Date (if known)
MonthDayYear
Date
PC Make and Model
MakeModel
CPU Speed
Number of Cores
Is the PC connected to a UPS (Uninterrupted Power Supply)?
YesNo
Installed RAM
i.e., 8GB, 16GB
Type of Device
Operating System
Version
Microsoft Office
YesNo
Version
Type
Srv Pack
Additional Notes:
Do you need to add another workstation?
YesNo
If you do not have any additional workstations to add, continue through the next pages and STOP at LOB Applications to continue filling out this survey.

18. Workstation Configuration
PC Name
i.e., Operatory 1, Front Desk 2, Check-Out, Dr PC, etc.
Serial Number/Service Tag #
Warranty Date (if known)
MonthDayYear
Date
PC Make and Model
MakeModel
CPU Speed
Number of Cores
Is the PC connected to a UPS (Uninterrupted Power Supply)?
YesNo
Installed RAM
i.e., 8GB, 16GB
Type of Device
Operating System
Version
Microsoft Office
YesNo
Version
Type
Srv Pack
Additional Notes:
Do you need to add another workstation?
YesNo
If you do not have any additional workstations to add, continue through the next pages and STOP at LOB Applications to continue filling out this survey.

19. Workstation Configuration
PC Name
i.e., Operatory 1, Front Desk 2, Check-Out, Dr PC, etc.
Serial Number/Service Tag #
Warranty Date (if known)
MonthDayYear
Date
PC Make and Model
MakeModel
CPU Speed
Number of Cores
Is the PC connected to a UPS (Uninterrupted Power Supply)?
YesNo
Installed RAM
i.e., 8GB, 16GB
Type of Device
Operating System
Version
Microsoft Office
YesNo
Version
Type
Srv Pack
Additional Notes:
Do you need to add another workstation?
YesNo
If you do not have any additional workstations to add, continue through the next pages and STOP at LOB Applications to continue filling out this survey.

20. Workstation Configuration
PC Name
i.e., Operatory 1, Front Desk 2, Check-Out, Dr PC, etc.
Serial Number/Service Tag #
Warranty Date (if known)
MonthDayYear
Date
PC Make and Model
MakeModel
CPU Speed
Number of Cores
Is the PC connected to a UPS (Uninterrupted Power Supply)?
YesNo
Installed RAM
i.e., 8GB, 16GB
Type of Device
Operating System
Version
Microsoft Office
YesNo
Version
Type
Srv Pack
Additional Notes:
Do you have more than 20 workstations?
YesNo

Additional Information for Overall Site Survey
Attach Images Here
Browse Files
Cancelof
Should be Empty:

Site Survey

Technical Contact Information

Client Information

Site Information Executive Summary

Extended Contact Information

Business Hours of Operation

Access and Security

Employee Roster

Configurations

Printer and Peripherals

Line of Business Software Applications

Server Configuration

If you only have a single server, you may skip the next 2 pages.

Server Configuration (Cont'd)

Server Configuration (Cont'd)

1. Workstation Configuration

2. Workstation Configuration

3. Workstation Configuration

4. Workstation Configuration

5. Workstation Configuration

6. Workstation Configuration

7. Workstation Configuration

8. Workstation Configuration

9. Workstation Configuration

10. Workstation Configuration

11. Workstation Configuration

12. Workstation Configuration

13. Workstation Configuration

14. Workstation Configuration

15. Workstation Configuration

16. Workstation Configuration

17. Workstation Configuration

18. Workstation Configuration

19. Workstation Configuration

20. Workstation Configuration