This is a form to make the reporting of problems consistent, allow records of problems to be kept, and a method of discouraging users from reporting faults in the first place.
 
 

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__