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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. How tall are you? Are you above this line? ____________________

16. 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 ___
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