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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Email
This field is for validation purposes and should be left unchanged.

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