Client Intake Form

Submission Instructions:

Please complete all relevant sections of this form.
Return the completed form to your NGC account manager or submit via the client portal.
For any questions or further clarifications, please contact info@nextgencampaigns.com.

Client Information

Company Name:

Primary Contact Name:

Contact Information:

Phone:

Email:

Address:

Street:

City/State:

Zip Code:

Client Industry/Vertical:

Preferred Method of Communication

Email Phone Other:

Service Requirements

Selected Service Tier:

Basic Silver Gold Platinum

Additional Services (if any):

Help Desk Support Custom App Development Database Development Other:

Specific Requirements or Goals for the IT Services:

Do you require any specific compliance or security measures (e.g., GDPR, HIPAA)?

Yes No

Current IT Infrastructure

Current IT Setup Description (Hardware and Software):

Number of Workstations:

Number of Servers (and details if available):

List of Critical Applications (CRM, ERP, etc.):

Any existing cloud services in use?

Yes No

Security Setup

Current Security Measures in Place:

Past Security Incidents (if any):

Description of incident and resolution:

Specific Security Expectations or Requests:

Additional Information

Any existing IT support or previous vendors?

Yes No

Anticipated Challenges or Concerns:

Preferred Onboarding Timeline:

Client Acknowledgment

Client has reviewed and agrees to the Terms of Service and SLA as provided

Yes No

Signature of Authorized Individual:

Date

Usage of the Intake Form:

Purpose: This form is intended to streamline the collection of vital client information necessary for tailoring NGC’s IT managed services to the specific needs and infrastructure of the client.
Processing: Once received, the form should be reviewed by the account manager to ensure completeness, followed by a detailed discussion with the client to refine needs and expectations before beginning the technical onboarding process.

Start the conversation with a free 10-minute consultation

Let’s discuss IT strategy, services, and business solutions & compliance concerns.

Submission Instructions:

Client Information

Contact Information:

Address:

Service Requirements

Specific Requirements or Goals for the IT Services:

Current IT Infrastructure

Security Setup

Additional Information

Client Acknowledgment

Usage of the Intake Form:

Start the conversation with a free 10-minute consultation

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