Scan and Penetration Test Order Form
Please fill out this questionnaire to begin to start the process for a vulnerability scan and penetration test.
Please answer the questions as accurately as possible as any incomplete or missing information may result in the delay of service.
Not all questions will be applicable to each assessment. Please input 'N/A' to any questions that do not require an answer.
Completing and submitting this form authorizes SOClogix to perform penetration testing and network vulnerability testing against the IP information listed in the questionnaire.
If you have any other questions or need assistance with this form please contact firstname.lastname@example.org
Reseller / Partner Name * Contact and General Information
Enter all the following contact information for your client receiving the Vulnerability Scan and Penetration Test.
Contact Person Email * Contact Phone Deployment Type
Please select the type of deployment for this scan. The following types of deployment options are available:
On-site Scanner Box - Best used for scans where there is no access to install an agent on the domain controller or install software agents on.
Agent on Domain Controller - Best used for scans where this is access to the domain controller to install a probe.
Software agent on all Windows, MAC, and Linux devices - Best used when there is no central domain authentication available.
When should active portions (scanning, enumeration, exploitation, etc.) of the penetration test be conducted? (check all that apply) Please note that devices need to be powered on and connected to the network in order to be included in the assessment.
Has your organization ever been compromised, if so please describe the compromise and remediation. Assessment Network Information
Is the penetration test required for a specific compliance requirement (HIPAA, FINRA, PIC, etc.)?
Who is the current Internet Provider? External IP Information:
Please list all External IP address blocks registered to your organization. (for example, 12.34.56.x/24)
Internal IP Ranges
Please list our all IP ranges that are to be tested?
Please be sure to include all subnets that are accessible by the network.
Please list all domain names registered to your organization. (for example, abcsales.com and/or abcsupport.com, etc.)
Does your organization use a local firewall(s)?
If so, please list the quantity and manufacturer(s) of the firewall(s).
What server technologies does your organization use?