Trouble Ticket Form

Use this form to submit a request for service on your computer. Harmony Computing will reply within 6 hours. Please note the required fields.

(Section 1 of 7) Your Information:

Name:
Telephone:
E-mail:
Company Name:
Street Address:
City:
State/Zip:	Zip Code:
Referred by:

(Section 2 of 7) Problem Details:

Frequency: (check all that apply)	constant intermittent when on Internet upon executing certain programs (please specify below) sometimes
Problem Description:
Performance Measurement:	Set your watch. From the time you turn on your computer to the time the hour glass disappears:how many seconds/minutes does this take?
Computer Environment:

(Section 3 of 7) System Details:

Make:
Model:
Select Type:
Operating System:
Office Productivity Software:
LAN:	Is this computer part of a LAN? Yes \| No
Service Pack Downloads are:	Current \| Incomplete \| Unknown

(Section 4 of 7) Internet:

Internet Connection Type:
Internet Service Provider (ISP):
ISP if "other" above:
(For AOL Users) Updates are:	Current \| Incomplete \| Unknown
E-mail Software:

(Section 5 of 7) Security:

Last Backup:
Recovery Strategy:	If you lost everything on your hard drive, what would you do?
Anti-Virus:	Product: Version:

(Section 6 of 7) Peripherals:

Please list all peripheral devices (printers, scanners, external drives, etc.) connected to this computer. If there are more than 5, please list in the OTHER COMMENTS field.

#	Peripheral Type	Manufacturer	Model #
1
2
3
4
5

(Section 7 of 7) Other Comments

Please furnish any other information that you think would assist us in trouble-shooting and solving your problem here: