Client Consent Form

Littleman IT Tech Solutions Client Consent Form
Please download this form and email it back to us or fax it.
1. Parties Involved
This Consent Form is made and entered into on [Date______________________], by and between:
  • Service Provider: [Littleman IT Tech Solutions] with a business address of [1807 W. Pullen Street, City: Pine bluff, State: Arkansas, and zip code of 71601] and contact information [Company Phone Number: (479-265-1688)
  • [Email Address of customerservices@littleman.itsolutions.vibe-ly.com] (hereinafter referred to as the (“Littleman IT Tech Solutions “).
  •  Client Name: ______________________________ with a mailing address of
  • [Client Address: __________________________   City: _______________________
  • State: ______________________   zip code: _______ and contact information
  • Customer Mobile Phone Number:(     ) _______________
  • Client Email Address of: _____________________________
  • (hereinafter referred to as the “Client”).
2. Purpose of this Form
The purpose of this form is to obtain the Client’s informed and consent for Littleman IT Tech Solutions to perform IT support, Monitoring, Management, Maintenance, and/or troubleshooting services on the Client’s computer systems, network, and/or other devices (hereinafter referred to as the “Equipment”).
3. Description of Services
The Client hereby authorizes Littleman IT Tech Solutions to perform the following services:
  • [Describe the specific IT issue or the nature of ongoing support, e.g., Monitoring, Management, Maintenance, “diagnose and repair a non-functioning laptop”, “perform routine network maintenance”, monitoring, management “install new software”, etc. and whatever the plan they as [Client] choose and its description in that plan]
  • Littleman IT Tech Solutions may require unrestricted access to the Client’s Equipment, files, and network to perform these acts effectively.
4. Potential Risks and Disclaimers
The Client acknowledges and understands that while Littleman IT Tech Solutions will exercise reasonable care and industry-standard practices, IT support work inherently involves some risks. These may include, but are not limited to:
  • Data Loss: Although unlikely, there is a risk of data loss or corruption during certain procedures (e.g., hard drive replacement, system reinstallation, data transfer). The Client is solely responsible for backing up all critical data, files, and software prior to any work being performed unless it is included in their plan or have one of our backup and storage plans in place
  • System Downtime: Services may cause temporary interruptions to the Client’s business operations or personal use of the Equipment.
  • Unforeseen Issues: Additional problems or incompatibility issues may arise that were not initially apparent.
5. Confidentiality and Data Handling
Littleman IT Tech Solutions agrees to:
  • Maintain the confidentiality of all personal and business information the Client provides or to which Littleman IT Tech Solutions gains access.
  • Use the Client’s data solely for the purpose of performing the agreed-upon services.
  • Implement security measures consistent with industry standards to protect the Client’s data while under Littleman IT Tech Solutions control.
  • Promptly notify the Client in the event of any data breach or security incident.
6. Limitation of Liability
The Client agrees that Littleman IT Tech Solutions liability for any direct or indirect damages, including data loss, loss of profits, or business interruption, is limited to the total amount paid by the Client for the specific services rendered under this form. Littleman IT Tech Solutions is not responsible for losses caused by the Client’s failure to back up their data.
7. Voluntary Participation and Right to Withdraw
The Client understands that this consent is voluntary. The Client may withdraw their consent at any time by providing written notice to Littleman IT Tech Solutions. Upon withdrawal, Littleman IT Tech Solutions will cease work, and the Client will be billed for services rendered up to that point.
8. Client Acknowledgment and Signature
I, [Printed Client Name: _______________________________ have read and understand the terms and conditions outlined in this Consent Form for Littleman IT Tech Solutions. I have had the opportunity to ask questions and my questions have been answered to my satisfaction. I am aware of the potential risks and the limits of liability, and I agree to proceed with the services described. I confirm that I have backed up my data (or) have one in place with Littleman IT Tech Solutions.
  • Client Signature: _________________________
  • Date: [Date] _______________________
9. Service Provider Acknowledgment
  • Provider Signature: _________________________

Company Name: Littleman IT Tech Solutions