Technical Support Request Form
Due to a change in the company's operating procedures, all
technical support requests will need to be initiated by first filling in the form below. When completed, place into the
Information Management inbox (also known as the
wastebasket).
COMPUTER PROBLEM SELF-REPORT FORM
1. Describe your problem:
__________________________________________
2. Now, describe your problem accurately:
__________________________
3. Speculate wildly about the cause of the problem:
________________
4. Problem Severity:
A. Minor ___ B. Minor ___ C. Minor ___ D. Trivial ___
5. Nature of the problem:
A. Locked Up ___ B. Frozen ___ C. Hung ___ D. Shot ___
6. Is your computer plugged in?
Yes ___ No ___
7. Is it turned on?
Yes ___ No ___
8. Have you tried to fix it yourself?
Yes ___ No ___
9. Have you made it worse?
Yes ___
10. Have you read the manual?
Yes ___ No ___
11. Are you sure you've read the manual?
Yes ___ No ___
12. Are you absolutely certain you've read the manual?
No ___
13. Do you think you understood it?
Yes ___ No ___
14. If 'Yes', then why can't you fix the problem yourself?
__________
15. What were you doing with your computer at the time the problem occurred?
________________________________________________
17. If 'nothing', explain why you were logged in:
___________________
18. Are you sure you aren't imagining the problem?
Yes ___ No ___
19. How does this problem make you feel?
___________________________
20. Tell me about your childhood:
___________________________________
21. Do you have any independent witnesses of the problem?
Yes ___ No ___
22. Can't you do something else, instead of bothering me?
Yes ___ Yes ___
Taken from an unknown source.