Millennium Business Solutions
Digital Site Survey

Tell us about your work environment. Please use the form below to submit your digital assessment survey information. Provide as much information as possible and one of our MBS Sales Associates will contact you shortly.

CUSTOMER INFORMATION:
Your Name:*
Address:
City:
State:
  ZIP: 
Phone Number:
Email Address:*
GENERAL INFORMATION:
Model of equipment to be installed?
By who? Onsite IT Staff   Outsourced IT Staff
If "Outsourced IT Staff" Selected:
Company Name:
Contact Name:
Contact Phone:
Will IT be present for Install?   YES   NO
SERVER INFO:
Server Name:
Operating System:
Processor:
Is the server onsite?   YES   NO
Will print driver be installed on server?   YES   NO
Will customer have Admin Password?   YES   NO
Are you running terminal services?   YES   NO
What Anti-Virus Software/Suite is being used?
CLIENT INFO:
What operating systems are clients running?
(select all that apply)
Windows 95
Windows 98
Windows 2000
Windows XP
Other
Windows Vista
Windows 7
Mac OS
Linux
If "Other" please list:
MFP SOFTWARE:
What software is being installed?
(select all that apply)
Sharpdesk
PC Fax
Scan to email
Scan to network folder
Printing
Other
If "Other" please list:
EMAIL INFORMATION:
Are you currently running an email server?   YES   NO
If "YES" please list:
If "YES" what is the hostname IP Address?
Does the server require sender validation?   YES   NO
Does the server require authentication?   YES   NO
Can accounts be setup in Active Directories?   YES   NO
NETWORK INFORMATION:
Is there a network plug/jack close to the machine?   YES   NO
Is there a Firewall being used?   YES   NO
If "YES" please list:
Should MBS provide the cable(s)?   YES   NO
If "YES" what lenght(s)?
IP CONFIGURATION INFORMATION (optional):
With what IP address will the device need programmed?
IP:
Subnet Mask:
Default Gateway:
Primary DNS:
Secondary DNS:
Internet Provider:
ADDITIONAL INFORMATION:
Special Comments:
Security Code:*
Re-type the Code here
*- Indicates required fields.
   
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