DCDIAL | New Client Questionnaire

Customer Details

(** required fields)

**Company Name

**Name

**Company Website

**Title

**Email

**Address

**Address2

**City

**State

**Zipcode

**Phone

**How did you hear about us?

**Anticipated Daily Call Volume

**Number of Office Locations

**Number of Agents

**What type of phone system are you currently using?

**What types of phones do you have? (Make/Model)

**Who is your Internet Service Provider (ISP)?

**What type of Internet Connection do you have (i.e. T1, Fiber, Cable, DSL)?

**Bandwidth

**Do you have a Firewall? (if yes, make/model)

**Sign me up for Regional Caller ID

YES NO

**Attach File Format With Test Data (that you will be sending to DCDIAL)

**Attach File Format With Test Data (that you wish to receive from DCDIAL)

**Company IP Address

Additional IP Address

** Please enter the security code