Rep Portal for FaxSIPit

Zoom Fax Needs Assessment

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1. Rep Information
Rep Name*
First Last
Rep Email*
2. How you are currently using fax
How does your company send/receive faxes now? Check all that apply
- Virtual fax (email to fax | fax to email)
- Print to Fax (fax print driver)
- Fax Machine (fax capable hardware device)
- Web to Fax (web page that sends a fax)
How many fax users do you have?*
How many physical fax devices do you have?*
What is the monthly usage in fax pages total?*
Expected usage is ok too. Approximation is fine.
Do you have any fax compliance needs? (HIPAA, FISMA, CCPD, GDPR, etc.)*
- No
- Yes
Please list or describe your fax compliance needs.*
If this is a change in your workflow process, please describe the change.
3. Fax numbers
How many fax numbers do you have?*
Approximation is fine.
Do you need any new fax numbers?*
- No
- Yes
Do you have any Toll Free fax numbers?*
- No
- Yes
Do you have any offices outside of US & Canada that require fax numbers? If so please list the countries:
4. Additional information
Do you have a monthly budget constraint or requirement you need, if so what is the amount?
Do you have a timeline for when this should all be completed?
Date Format: YYYY dash MM dash DD
5. Primary Contact and Company Details
Primary contact name*
First Last
Primary contact email*
Primary contact phone number
Company name*
Company website
Company phone number
Company fax number
Company address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
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Name
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Zoom Fax Needs Assessment

1. Rep Information

2. How you are currently using fax

3. Fax numbers

4. Additional information

5. Primary Contact and Company Details