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)
- Fax Machine (fax capable hardware device)
- Web to Fax (web page that sends a fax)
How many virtual fax users do you have?*
How many physical fax devices do you have?*
What is the monthly usage in fax pages or minutes total?*
Expected usage is ok too. Approximation is fine.
Do more than one person share a fax number?*
- No
- Yes
Please describer the way you fax now, If it is different than above or if more details are required:
Do you have any fax compliance needs? (HIPAA, FISMA, CCPD, GDPR, etc.)*
- No
- Yes
Please list or describe your fax compliance needs.*
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?
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
Hidden
Company fax number
Company address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
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Comments
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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