Client Inquiry Form - Remote Staff Solutions

Company Name *

Company Address *

Operating Hours *

Nature of Business/Field of Operation *

If you chose 'Other', please specify

Name Primary Contract Person *

Position of Primary Contact Person *

Primary Contact Person Email *

Primary Contact Person Phone Number *

Name Secondary Contract Person

Position of Secondary Contact Person

Secondary Contact Person Email

Secondary Contact Person Phone Number

Name and Position of Client Agreement Signatory *

Company Website *

What type of help do you need from a remote staff? *

If you chose 'Other', please specify

How often will you need help from your remote staff? *

Part-Time (at least 20 hours/week)
Full-Time (40 hours/week)

Kindly specify the official working hours that the remote staff will follow (example: M-F, 8 am-5 pm EST)

Please note any special requirements you will need from the remote staff (example: must be adept in using EMRs/ must be experienced in QuickBooks).

What communication channels do you use in your office that the remote staff will be using? You may select all that apply.

What type of phone system do you use in the office? *

If you selected "Other Phone Software" in the previous question, please specify your phone software here.

If you will require the use of a software/s, please specify the type and the brand/label you are using. List all that apply to the remote staff. (Example: EHR- Dr. Chrono, Accounting Software- QuickBooks, etc.) (copy)

When would you like to have the remote staff deployed? Please give us at least 10 days to process your request.

Do you have a preferred day/time of the week for an interview with the remote staff? (example: Wednesdays from 8 am to 12 nn)

Thank you for answering all our questions. Someone from our team will be in touch with you to provide more details about your request. What is the best date and time to call you? (You will be contacted through the email or phone number you provided).