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  • AUTHORISED Primary Contact Point
  • SERVICE DETAILS (PLEASE PROVIDE THE NAME OF AT LEAST 1 SERVICE REQUIRING A HEALTH CHECK)
  • Service Type
  • I REQUEST THE FOLLOWING REVIEW (CHARGED PER SERVICE)
  • Charges above are at a per service basis, If you have multiple services you would like reviewed please
    add details to the comments area below.
  • Authorisation of Admin User *
  • I authorise for a new Administration user to be set up to access my database for the purposes of the QK Health Check and authorise for this user to be used for this purpose only. On completion of the Health Check the user will be locked out of the database to prevent any further access. If the Health Check results in additional work to be done through this user account, I will be further notified and updated.

  • Authorise Access Report *
  • I acknowledge that QK Technologies and it's authorised partners will access and report on my service/s as described in the QK Health Check overview and I will be provided with a report on my service/s detailing all outcomes.