Meet With Us

Scan and Pen Test Order Form

SOClogix > Scan and Pen Test Order Form
Please enable JavaScript in your browser to complete this form.

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 soc@soclogix.com

Thank you,

Contact and General Information

Enter all the following contact information for your client receiving the Vulnerability Scan and Penetration Test.

Enter the name for your client who is receiving the Scan and Penetration Test.
Contact Person
Assessment Address:
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.



Scan Times
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.

Assessment Network Information

Compliance Requirements:
Is the penetration test required for a specific compliance requirement (HIPAA, FINRA, PIC, etc.)?
Please list all External IP address blocks registered to your organization. (for example, 12.34.56.x/24)
Approximately how many onsite devices are on your network? This number includes desktops, laptops, servers, printers, network devices, VOIP phones, and IoT devices (thermostats, POS systems, Ring doorbells, etc.).
Approximately how many onsite devices are part of your organization but not at any office or network location? This number includes desktops, laptops, servers, printers, network devices, VOIP phones, and IoT devices (thermostats, POS systems, Ring doorbells, etc.).
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).
Server Technology:
What server technologies does your organization use?
What database technologies does your organization use?
Please list any IP addresses related to printers, VOIP, or VLANs in order to prevent any potentially dangerous scans to the equipment.