| Please
complete the following information to begin your request with
EPIC IT Engineers. The information provided here will
immediately be forwarded to the next available engineer.
Items marked with a red * are
required to complete your request.
|
| 1. |
Name of your company: |
* |
| 2. |
Name of individual
submitting the request: |
* |
| 3. |
Name of individual
needing service/support: |
* |
| 4. |
Telephone or cellular phone, or number: |
*
(example: 404-249-7523) |
| 5. |
E-mail address |
|
| 6. |
Indicate the type of
problem or request needed: |
* |
| 7. |
Indicate the severity
of the issue: |
*
(see below for
details) |
|
Severity |
Description |
|
A |
Halts departmental/company
operation (example: server down, internet connection
failure) |
|
B |
Halts individual operation (example: loss of power
on PC, Windows errors) |
|
C |
General inconveniences (example: E-mail problems,
phone reprogramming) |
|
D |
General wants or requests (example: special
research, database query) |
|
|
| 8. |
Enter a brief
description of the problem: |
* |
| 9. |
Describe your problem and/or request. (Please be complete
in your description. Include ideas you may have as to why this happened.
EXAMPLES: working on a very large documents, wrong paper inserted in
printer, bad e-mail address, etc.) * |
|
|
10. |
Did you get an error message?: |
Yes
No *
(If so, please complete item #10; otherwise #11) |
|
11. |
Please enter
the error message using CUT (ctrl C) and PASTE (ctrl V) or other text
that might be important to solve your problem. |
|
|
12. |
Can you
recreate this problem?: |
Yes
No *
(If so, please complete item #12; otherwise #13) |
|
13. |
Please enter
the steps to recreate your problem or error: (example: 1.open
outlook, 2. use send/receive, 3. pop-up error box) |
|
|
14. |
Have you
experienced this problem before?: |
Yes
No * |
|
15. |
Completion Date Required/Requested: |
*
(example: 03/28/2004) |
|
16. |
Best
time of day for repair/contact: |
*
(example: 5:00pm) |
|
17. |
For
tracking purposes, EPIC assigns a unique task number to each
ticket. Your ticket number appears to the right.
Please copy this number into #18 below. Please refer
to this number when requesting a task update. |
 |
|
18. |
Your
task number for this ticket is ... |
*
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