COMPUTER PROBLEM REPORT FORM

PLEASE FILL IN THIS FORM COMPLETELY

1. Describe your problem:

2. Now describe the problem accurately:

3. Speculate wildly about the cause of the problem:


4. Problem Severity:
Minor
Minor
Minor
Trivial

5. Nature of the problem:
Locked Up
Frozen
Hung
Shot

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 read the manual?
Yes
No

11. Are you sure you read the manual?
Yes
No

12. Are you absolutely sure you have read the manual?
No

13. Do you think you understood it?
Yes
No

14. If Yes then why can't you fix the problem yourself?

15. How tall are you? Are you above this line? __________________

16. What were you doing with your computer at the time the problem occurred?

17. If nothing, explain why you were logged in.


18. Are you sure you are not imagining the problem?
Yes
No

19. How does this problem make you feel?

20. Tell me about your childhood.


21. Do you have any independent witnesses of the problem?
Yes
No

22. Can't you do something else instead of bothering me?
Yes