Maintenance Intake Form – Kindred Technology Group

Maintenance Intake Form
Please enable JavaScript in your browser to complete this form.1Client Information2Current Website Status3Website Credentials4Hosting Information5Preferred Communication Method6Emergency Contact InformationFull Name *Company/Organization Name *Email Address *Phone Number *Website URL *Briefly describe any existing issues or concerns with the website. *WordPress Admin URL *Username *Password *Hosting Provider *Control Panel URL *Hosting UsernameHosting Password
Preferred Communication Method *
Email
Phone
Text Message
Emergency Contact NameEmergency Contact Phone Number *Any specific instructions for emergenciesAdditional Comments or Instructions *
Allow the client to provide any additional information or specific instructions. *
Allow the client to provide any additional information or specific instructions.
Allow the client to provide any additional information or specific instructions.
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January 3, 2024