IT Support Renewal Intake – Ask Charley Bach

Confirm Your Client Profile

Take a few minutes to confirm your contact, environment, and billing details. I use this to keep your account current and make sure service runs smoothly.

Client Identification

Are you an existing client? *

Please indicate whether you are an existing client.

Full Name *

Full name is required.

Email Address *

A valid email address is required.

Phone Number *

Phone number is required.

Account / household / organization name *

For residential clients, this can be your household name (example: Smith Household).

Account or household name is required.

Contact Confirmation

Is your contact information still current? *

Please confirm whether your contact information has changed.

Updated Phone Number

Leave blank if phone has not changed.

Updated Address

Leave blank if address has not changed.

Preferred Contact Method *

Please select your preferred contact method.

Environment Overview

Number of Users *

Number of users is required.

Number of Computers *

Number of computers is required.

Has your environment changed since we last worked together? *

Please indicate whether your environment has changed.

Describe What Changed

New hardware, software, locations, or anything else relevant.

Service Relationship

Service Arrangement *

Service arrangement is required.

Are you interested in proactive maintenance coverage? *

Please indicate your interest in maintenance coverage.

Is remote support access permitted for your systems? *

Please indicate whether remote support is permitted.

Billing Confirmation

Is your billing email the same as your primary email? *

Please confirm your billing email preference.

Billing Email Address *

A valid billing email is required.

Name to Appear on Invoices *

Invoice name is required.

Tax Exempt Status *

Tax exempt status is required.

Consent