EZTube Network Assessment

If you would like to talk to someone send us a text at 773-830-3763. We are available from 9am to 9pm USA Central Time. Thanks!

To help fill this form out you can either download speedtest by Ookla  from your respective app store or click on the link below. We are only interested in the download speed.

https://www.speedtest.net/

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

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Email *

Phone *

Who referred you to CTC? *

Who is your Internet Service Provider? *

Please go to speedtest.net on your phone or computer and enter the download speed # *

To check your speed was your device on the WiFi or Hard Lined via Ehternet Cord to the router? *

• WiFi
• Hard Lined via Ehternet Cord

If you used Wifi, how far away were your from your modem/router? *

• 2 FT or less
• 5 FT or more
• In a different room

How many TV's are you looking to connect? *1234

If you have more than 4 TV's please indicate in the notes below, there will be special pricing for more than 4 TV's.

Do you have coax cable running to all your tv's that you would like setup? *

• Yes
• No

Do you have Ethernet ran to your TV locations? *

• Yes
• No

Is your modem/router within 10ft of your main TV? *

• Yes
• No

If yes, is it aesthetically pleasing to run an Ethernet cord from the modem to that TV? *

• Yes
• No

Is your modem/router from your current ISP provider? *

• Yes
• No

If no, please provider the model of your modem and router.

How would you rate your technical skill? *

• 1-5
• 6-7
• 8-10

Notes or Questions

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