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Intake form
Help us serve you better
Name
*
Email address
*
What services are you interested in?
Please select at least one option.
Advanced parental controls
Website filtering
Wi-Fi security
Ongoing support
What devices do you want to secure?
Please select at least one option.
Smartphones
Tablets
Laptops
Desktops
Smart TVs
Gaming consoles
How many children do you want to protect online?
Select
1
2
3
4
5 or more
What age range are your children in?
Please select at least one option.
0-5 years
6-10 years
11-14 years
15-18 years
Do you currently have any security measures in place?
Select
Yes
No
How did you hear about us?
Please select at least one option.
Social Media
Word of Mouth
Search Engine
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Additional questions or comments
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