Business Name
Primary Contact
First Name
Last Name
Phone Number
Email Address
Billing Email (if different)
Billing Address
Address
Suite No.
City
State
Zip
Primary Location
Address
Copy Billing Address
Address
Suite No.
City
State
Zip
Personnel
Full-time users on site
Full-time remote users
Part-time users on site
Part-time remote users
Email Accounts
Assets
Networking Equipment
Desktops
Laptops
Servers
Server Details (domain controller, medical software, etc.)
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Additional Notes or Requests
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