Chromebook Damage Form
Please use this form to report damage to student Chromebooks. Reports are automatically sent to the HMS Library, Tech Services, and HMS Administration. You will also receive a copy of the completed form via email. Please provide as much detail as possible.
Email address *
Student Name *
Your answer
Student building / homeroom *
Asset Tag Number *
This is the 8-digit barcode number on the bottom of the Chromebook: 2013####
Your answer
Dell Service Tag Number *
This is the number imprinted on the bottom of the Chromebooks above a barcode.
Your answer
Damage Description *
Detailed Damage Description *
Describe the damage in detail, or provide more information on what is happening when using the Chromebook
Your answer
Student statement *
Please explain what happened just before the Chromebook was damaged.
Your answer
Additional notes
Your answer
A copy of your responses will be emailed to the address you provided.
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