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Prospective Customer Inquiry Form

Thank you for your interest in Qwest products and services. Please fill out the questionnaire below and a sales representative will contact you within 24 hours of your submission.

If you are not a fit for the wholesale segment, please contact Qwest Retail Business, Qwest Residential, or the Qwest Business Partner Program.


  1. Are you a current customer of Qwest?

  2. *What is your estimated monthly telecom billing?



  3. What type of customer are you?

    499 Licensed Carrier*
    Agent
    Cable Systems Operator/MSO
    Content Provider
    Facility Based CLEC and Non-Facility Based CLEC
    ISP/ESP
    Independent Local Exchange Carrier
    Interexchange Carrier
    International Service Provider
    Reseller
    Wireless Service Provider
    VoIP Provider


  4. Please provide your contact information.

    *Contact Name:
    		 *Title:
    *Full Legal Company Name:
    		 *Headquarter Location:
    *Email:
    		 *Telephone:


  5. Please let us know what type of services interest you, or feel free to submit general questions, comments or requests:



* Required Fields
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