Repair Request Form - Thomas H. Dudley Family School
Upon completion a Troubletrakker will be issued and a technician or repair vendor will be assigned to address the reported problem. The technology coordinator will provide you with a completed repair form that should be taped to the equipment in need of repair or removal.
Please complete this survey for each individual issue.
Each request is time stamped and dated.
Thank you.
Name *
Your answer
Room # *
Your answer
Issue * *
Please identify your technology problem.
Your answer
ISSUE *
EQUIPMENT TYPE/MODEL * *
Example: Dell/ Optiplex 750
Your answer
Serial Number* *
(Service Tag # on Dell) Please note that request will not be processed without the serial or service tage number.
Your answer
CHECKLIST FOR REPAIRS* *
Prior to submission, please verify that the following items have been completed:
DESCRIPTION *
Please describe the existing problem with the equipment,in detail:
Your answer
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