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NEXA AUTOMATION LLC
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Intake form
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Name
*
Email address
*
What type of business do you operate?
Select
Retail
Manufacturing
Healthcare
Finance
Technology
Education
What specific processes are you looking to automate?
Please select at least one option.
Data Entry
Reporting
Customer Service
Inventory Management
Compliance
Sales
What is the size of your business?
Select
Small (1-10 employees)
Medium (11-50 employees)
Large (51+ employees)
What automation technologies are you currently using?
Please select at least one option.
None
Robotic Process Automation (RPA)
Workflow Management Systems
Artificial Intelligence
Data Analytics Tools
What is your primary objective for automation?
Select
Increase Efficiency
Reduce Costs
Improve Accuracy
Enhance Customer Experience
Scale Operations
What is your preferred method of contact for follow-up?
Select
Email
Phone
In-Person Meeting
What is your expected timeline for implementing automation solutions?
Select
Immediately
Within 1-3 months
Within 3-6 months
Within 6-12 months
No specific timeline
What budget range do you have in mind for automation solutions?
Select
Less than $5,000
$5,000 - $10,000
$10,000 - $25,000
$25,000 - $50,000
Over $50,000
Additional questions or comments
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