New Cloud Assessment
Title
*
Name
*
First Name
Last Name
Practice and Doctor Name
*
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Back
Next
Hardware Assessment
Workstations
How many workstations/computers?
*
Are all computers hardwired (no wireless connection?)
*
Yes
No
Are all computers on Windows 10 Pro or higher?
*
Yes
No
If "No" what operating system are they?
Back
Next
Hardware Assessment
Peripherals
Are all printers hardwired with ethernet connections?
*
Yes, all have ethernet connections
No, all are wireless printers
Some are Ethernet and some are Wireless
How many printers?
*
Are there any Dymo Label Printers used for labeling charts?
*
Yes, we use dymo label printers
No, we no not use dymo label printers and are happy with our solution
No, we do not use dymo label printers but are interested in that solution
Does your office have any document scanners?
*
Yes, we have document scanners
No, we do not have or need document scanners
No, but we are interested in having document scanners
Does your office use signature pads?
*
Yes, my office uses signature pads
No, my office does not use signature pads
No, my office does not use signature pads but is interested in this solution
Please list make/models:
Does the office use credit card readers?
*
Yes
No
No, but we are interested in using them
Please list make/model of credit card readers:
Do they integrate with your software?
Yes
No
Back
Next
Hardware Assessment
Dental Specific Equipment
Do you have any intra-oral sensors?
*
Yes, we use intra-oral sensors.
No, we do not use intra-oral sensors.
No, we do not have intra-oral sensors but are interested in using them
If yes, how many sensors?
If yes, what are the make/model of the sensors?
Ex. Sirona
Do you have any intra-oral cameras?
*
Yes, we use intra-oral cameras.
No, we do not use intra-oral cameras
No, we do not have intra-oral cameras but are interested in using them
If so, how many cameras?
If yes, what are the make/model of the cameras?
Ex. Mouthwatch
Does the office use Vital Monitors?
*
Yes, we use vital monitors
No, we do not use vital monitors
No, we do not use vital monitors but are interested in them
How many Vital Monitors?
Please list Make/Model of Vital Monitors:
Will serial port cables be needed?
Yes
No
What model of serial port cables?
Do they integrate with your software?
Yes
No
Back
Next
Hardware Assessment
Xray Machines
Do you use ScanX or Optime in the office?
*
Yes, we use ScanX or Optime
No, we do not use ScanX or Optime
No, we do not use ScanX or Optime, but we are interested in this solution.
If yes, what make/model?
Does the office use any Pano Machines?
*
Yes, Digital Pan 2D
Yes, Digital Pan 3D
Yes, Digital Pan 2D and 3D
No, we do not use Digital Pan
No, we do not use Digital Pan but are interested in this solution
If yes, Make/Model/Serial #
If yes, what software do you use?
Back
Next
Hardware Assessment
Network and Equipment
Who is your internet service provider (ISP)?
*
What type of router does the office use? (make/model/provider)
*
Will anyone access The Complete Cloud™ via Wifi?
*
Yes
No
Does the office currently have a static IP?
*
Yes
No
Are you currently using SD-WAN dual internet technology?
*
Yes
No
No, but we are interested in this solution
If yes, who is the provider?
Does the office have any additional equipment listed below?
*
TVs with streaming services (ex. Netflix or Hulu)
Internet-based Audio Systems (ex. Sonos, Pandora, Spotigy)
No other additional equipment
Back
Next
Hardware Assessment
Phones
Do you have voice over IP (internet based) Phone system?
*
Yes
No
Who is your provider?
*additional information will be needed during The Complete Cloud™ deployment.
Back
Next
Software Assessment
Practice Management Software
What Practice Management software is the office using?
*
What is the version?
*
Are you planning to convert to another practice management software prior to coming to The Complete Cloud™?
*
Yes
No
Which practice management software do you plan to convert to?
Back
Next
Software Assessment
Imaging Software
Which imaging software are you currently using?
*
Are you using this software to take:
*
2D Images
3D Images
Both 2D and 3D images
Are you planning to convert imaging software before coming to The Complete Cloud™?
*
Yes
No
Which imaging software are you planning to convert to?
Back
Next
Software Assessment
Microsoft Services and Software
Who currently hosts the email for your office?
*
Are your email accounts encrypted?
*
Yes
No
Are you interested in having your email accounts encrypted?
Yes
No
How many Microsoft Office users does your office currently have?
*
(word, excel, powerpoint, etc)
Back
Next
Cloud Assessment
Additional Information
If there any additional software your office uses that you would like hosted in The Complete Cloud™?
While we cannot guarantee that all software will be compatible in your environment, we will make all reasonable attempts to discern if it should remain local or can be brought into your new environment. Please list all software or apps above for our review.
Do you have any other question for your cloud assessment representative?
Submit
Should be Empty: