Computer Problem Report Form
1. Please describe the
problem:_______________________________
2. Now, please describe the problem accurately:_________________
3. Speculate wildly about the cause of the problem:______________
4. Problem Severity: (please check one)
A. ___ Minor
B. ___ Minor
C. ___ Minor
D. ___ Trivial
5. Nature of Problem: (please check one)
A. ___ Locked Up
B. ___ Frozen
C. ___ Hung
D. ___ Strange Smell
6. Is your computer plugged in? Yes ___ No ___
7. Is it turned on? Yes ___ No ___
8. Have you tried to fix it yourself? Yes ___ No ___
9. Have you made it worse? Yes ___
10. Have you had a "friend" who "knows all about computers" try to fix it for you? Yes ___ No ___
11. Did they make it even worse? Yes ___
12. Have you read the manual? Maybe ___ No ___
13. Are you sure you've read the manual? Maybe ___ No ___
14. Are you absolutely certain you've read the manual? No ___
15. If you read the manual, did you understand it? Yes ___ No ___
16. If you answered "Yes" to question 15, then please explain why you can not fix the problem yourself: __________________________________________________________
17. What were you doing with your computer at the time the problem occurred? __________________________________________________________
18. If you answered "nothing", then please explain why you were logged in? __________________________________________________________
19. Are you sure you aren't "imagining" the problem? Yes ___ No ___
20. Do you have a copy of "PCs for Dummies"? Yes ___ No ___
21. Do you have any independent witnesses to the problem? Yes ___ No ___
22. Does the clock on your home VCR blink 12:00? Yes ___ What's a VCR ___
23. Do you have any electronic products that DO Work? Yes ___ No ___
24. Is there anyone else you can blame this problem on? Yes ___ No ___
25. Have you given the machine a good whack on the top? Yes ___ No ___
26. Is the machine on fire? Yes ___ Not Yet ___
27. Can you do something else instead of reading this? Yes ___