• Your name? ___________________
• Your login name? ____________________
• The date? __/__/__
• The date the problem first occured if different? __/__/__
• Problem Severity:

  Minor__		Minor__		Minor__		Minor__

• Which machine? ____________________
• Which area appears to be at fault?
  

  	Communications__	Disk__		Base Unit__
  	Network__		Keyboard__	Screen__	
  	Mouse__			Everything__	Don't Know__

  • Is it plugged in? Yes__ No__
  • Is it switched on? Yes__ No__
  • Has it been stolen? Yes__ No__
  • Have you tried to fix it yourself? Yes__ No__
    • Have you made it worse? Yes__
  • Have you read the manual? Yes__ No__
    • Are you sure you've read the manual? Yes__ No__
    • Are you absolutely certain you've read the manual? Yes__ No__
  • Did you understand it? Yes__ No__
    • If `Yes' then why can't you fix it yourself?
      _____________________________________________________________

  • Is the equipment unexpectedly noisy? Yes__ No__
    • If `Yes' what sort of noise?
      

      	Grinding__		Rattling__
      	Whirring__		High pitched whine__
      	Sound of disk head scouring disk__
      	Strange, out of tune whistling or humming__

  • Is there a smell of burning? Yes__ No__
    • If `Yes' is the equipment on fire? Yes__ No__

  • Is the fault repeatable? Yes__ No__

  • What were you doing (with the equipment) at the time the fault occurred? ______________________________________________________
    • If `nothing' explain why you were logged in. _______________________________________________________________

  • Are you sure you aren't imagining the problem? Yes__ No__
  • Do you have any independent witnesses of the problem? Yes__ No__
  • Describe the problem.
    _______________________________________________________________
  • Now, describe the problem accurately.
    _______________________________________________________________
  • Speculate wildly about the cause of the problem.
    _______________________________________________________________
    _______________________________________________________________
  • Can't you do something else, rather than bothering me? Yes__ No__

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