• NEW CLIENT QUESTIONAIRE

  • Company Name *
  • How did you hear about us? *
  • Name *
  • Phone *
  • Do you have a staff member(s) that you prefer as the Point of Contact?* *
  • Address *
  • How do you wish to be contacted? *
  • What practice management software do you use? *
  • Do you have a Dental Specific IT Provider? *
  • What made you look for a new IT provider? *
  • Do you have Firewall that is up to date? *
  • Do you have Anti-Virus Software that logs all attacks? *
  • Do you have an Secure Off and On-Site Backup System? *
  • Do you test your backups to see if they can be recovered from? *
  • Do your train your staff on HIPAA Compliance? *
  • Do you complete an Annual Risk Assessment? *
  • How can we help you? *