Oregon New Partner Intake Form

OREGON CLIENT INTAKE FORM

Partner/ Company Name(Required)

Address(Required)

City(Required)

State(Required)

Zip Code(Required)

Main Contact Name(Required)

Main Contact Email(Required)

Main Contact Phone(Required)

Billing Contact Name

MAIN CONTACT WILL BE LISTED IF NOT PROVIDED

Billing Contact Phone(Required)

Billing Contact Email(Required)

On-Site Point of Contact Name

MAIN CONTACT WILL BE LISTED IF NOT PROVIDED

On-Site Point of Contact Phone(Required)

The phone number is important for our employees to communicate if they are having trouble finding the space, are running late, etc.

On-Site Point Second Point of Contact(Required)

Project Description(Required)

e.g. Trimming, General Labor, Harvest, Retail, Various, etc.

Start Time(Required)

End Time(Required)

Lunch Length(Required)

30 Minutes, unless other specified

Entrance Notes(Required)

e.g. if you have a gate code, protected/hidden entrance, etc. This one is especially important for us because cannabis facilities are often blank and nondescript.

Bathroom(Required)

Onsite - Workspace Area

Onsite - Adjacent Area

Gender Specific

Portable

Breakroom(Required)

No Breakroom Available

Refridgerator

Microwave

Storage Space

Other - Please specify in notes section below.

Workplace area(Required)

Seating Details(Required)

is this a standing project or is seating provided? What kind of seating?

Important Notes / Information / Requests