Service Provisioning FormService ProvisioningPlease skip any questions you're unsure of. If we need any additional info, a tech will be in contact soon to ensure prompt delivery of your service.Name Email TechSurgeons Services Purchased Website Hosting Website Design Website Assistance Remote Technical Support Choose services purchased.Website HostingQuestions related to Website Hosting. Domain names, email addresses, type of setup required (new or transfer).Hosting Type New Website Transfer Existing Website Website Primary Domain NameYour website's primary domain name. i.e. techsurgeons.comAdditional Domain names Any additional domains you want linked to your website. i.e. <firstlast>.com points to <lastfirst>.com May require additional purchaseEmail Forwarding This list is for email addresses you'd like forwarded. i.e. contact@<example>.com to name@hotmail.comEmail Accounts This list is for email accounts you'd like created. i.e. yourname@<example>.comCurrent Web Hosting InfoPlease enter info about existing hosting setup. For example the web host's name, service expiration date, & a list of any email accounts you have with them. Please don't include any passwords here. We will contact you directly to schedule your move.Webite DesignQuestions to get us started on your website's new design.Site TitleYour Site Title is what's displayed in your web browser's tab info.Site TaglineIn a few words, explain what this site is about.Header ImageAccepted file types: jpg, gif, png, pdf, Max. file size: 2 MB.If you have a header image in mind for your site, upload it here. We may need to crop the image to match your site's theme. For your protection, please ensure you have the right to use all images.Background ImageAccepted file types: jpg, gif, png, pdf, Max. file size: 2 MB.If you have a background image in mind for your site, upload it here. For your protection, please ensure you have the right to use all images.Social Media Accounts to be Listed Please list each social media site you want highlighted on your site.Page Names Please list your preferred page names. i.e. Home, Books, Blog, About, and Contact Preliminary TextIf you have any preliminary text for your pages, paste it here. We will show you how to edit and update new text.Website AssistanceQuestions to help us fix your website.Describe the Website GremlinsTell us what's broken or what features you'd like us to add.Who hosts your website? TechSurgeons Some other hosting company Other Hosting CompanyOther Hosting Company NamePreferred Day for Website Work MM slash DD slash YYYY When is your preferred day for us to work on your site?Other Scheduling InfoOther info on website assistance. For example, alternate dates and times for website work, your blog schedule, or any other info for scheduling purposes.Remote Technical SupportQuestions relating to us remotely connecting to a virused or otherwise malfunctioning computer. Requires somewhat working Internet connection, web browser, and Java plugin installed.Problem DescriptionIn as much detail as you can, describe the computer's behavior.Preferred Service Date MM slash DD slash YYYY Preferred date of remote service call. Please specify your timezone in the notes field.Preferred Service Time : Hours Minutes AMPM AM/PMPreferred time of remote service call. Please specify your timezone in the notes field.Additional scheduling infoPlease put your timezone info and include alternative good times/dates for service.Data Usage PolicyInfo provided on this form will only be used for its specific purpose. It won't be sold, whipped, or chopped.PhoneThis field is for validation purposes and should be left unchanged.Δ
