System Problem Report
The follwing form is one that we used at my former workplace. Perhaps some of you may find it useful in your own office.
System Problem Report
This form has been designed to make the reporting of computer problems consistent and facilitate the tracking of system difficulties. Please complete the form answering all questions.
1. Your Name:_____________________________________________ ____
2. Your Login Name:____________________________________________
3. Your Password:_________________________________________ _____
4. The date:_____________________________________________ ____
5. The date the problem first occurred, if different:__________________
6. Problem severity:
Minor:_____ Insignificant: ____ Slight: ____ Trivial: ____
7. Which machine?__________________________________________ ___
8. What appears to be at fault?
Communications:__________ Disk: __________ Base Unit: __________
Network:________________ Keyboard: ______ Screen: ___________
Mouse: _________________ Everything: _____ Don’t Know: _______
9. Is it plugged in? Yes:___ No:___
10. Is it switched on? Yes:___ No:___
11. Has it been stolen? Yes:___ No:___
12. Have you tried to fix it yourself? Yes:___ No:___
13. Have you made it worse? Yes:___ No:___
14. Have you read the manual? Yes:___ No:___
15. Are you sure you’ve read the manual? Yes:___ No:___
16. Are you absolutely certain you’ve read the manual? Yes:___ No:___
17. Did you understand the manual? Yes:___ No:___
18. If “Yes”, then why can’t you fix it yourself?_____________________
19. Is the equipment unexpectedly noisy? Yes:___ No:___
20. If “Yes”, what sort of noise?
High Pitched Whine:____ Whirring:_____ Rattling:_____
Grinding:_____ Sound of disk head scouring disk:_____
21. Is there a smell of burning? Yes:___ No:___
22. If “Yes”, is the equipment on fire? Yes:___ No:___
23. Is the fault repeatable? Yes:___ No:___
24. What were you doing (with the equipment) at the time the fault occurred? __________________________________________________ __
__________________________________________________ ___________
25. If “nothing”, explain why you were logged in.__________________
__________________________________________________ ______
26. Do you have any witnesses to the problem? Yes:___ No:___
27. Describe the problem:_____________________________________
28. Now, describe the problem accurately:_______________________
29. Speculate wildly about the cause of the problem:_______________
__________________________________________________ _______
30. Can’t you do something else, rather than bother me? Yes:___ No:__
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