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Intake form
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Name
*
Email address
*
What type of organization are you representing?
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Non-profit
Small business
Medium enterprise
Large corporation
Government agency
Educational institution
Healthcare organization
What services are you interested in?
Please select at least one option.
Vulnerability assessment
Penetration testing
Red teaming
Adversary simulation
Purple teaming
Application security
Cybersecurity training
What is your organization's primary industry?
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Finance
Healthcare
Education
Retail
Technology
Manufacturing
Government
What is your preferred method of contact?
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Email
Phone
Video conference
In-person meeting
How did you hear about us?
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Referral
Search engine
Social media
Event
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What is the size of your organization?
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1-10 employees
11-50 employees
51-200 employees
201-500 employees
501-1000 employees
1000+ employees
Do you currently have any cybersecurity measures in place?
Select
Yes
No
Not sure
What is your organization's annual budget for cybersecurity services?
Select
Less than $5,000
$5,000 - $20,000
$20,000 - $50,000
$50,000 - $100,000
Over $100,000
What are your primary concerns regarding cybersecurity?
Please select at least one option.
Data breaches
Compliance with regulations
Employee training
Phishing attacks
Ransomware
System vulnerabilities
What is your timeline for implementing cybersecurity services?
Select
Immediately
Within 1 month
Within 3 months
Within 6 months
Longer than 6 months
Which service or services are you interested in?
Please select at least one option.
Vulnerability assessment
Penetration testing
Cybersecurity training
Adversary Simulation
Purple Teaming
Application Security
Additional questions or comments
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