Chromebook Damage/Issue Report
This form is for STUDENTS, PARENTS, FACULTY AND STAFF to report when a chromebook has an issue. This includes any broken pieces of hardware, issues with the chromebook working properly, etc.
Student LAST Name
Student FIRST Name
Chromebook Serial Number
Date the damage or issue occurred:
Detailed description of damage or issue (just outline what is WRONG here, you will describe what happened next)
Please select all that apply below:
This was an accident
This was intentional
The item was stolen
The item was stolen and I have filed a police report
The chromebook started working improperly (not external, rather in internal issue)
Provide a detailed description of WHAT HAPPENED to cause this issue. If you do not know, describe all that you can about the timeline of when the issue started, what you've noticed, if it has been repaired before, etc. If someone else caused the damage, please share who it was and what occurred.
Is this a repeat issue and/or has the Chromebook been damaged before?
If applicable: Please provide all details of the police report for insurance for a stolen item. Please send in a copy of any documentation to your child's teacher or email to
. (provide details of all of your actions below)
Reported By: (STUDENT, PARENT, FACULTY, STAFF NAME)
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