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Technical Support Request

Contact Name (First, Last) (*)

Email Address (*)

Company or Satellite Name

Contact Phone Number (*)


Table Number

PC Number

Problems you are experiencing (Check all that apply)

The problem is (Describe what the PC or device does or does not do)

The problem started when (Describe what occurred)

The problem happens when (Describe what is running, what the person is doing when it starts, or any factor you think is related to the problem)

The problem has happened (How many times)

Requested Priority (*)

Please provide the reason for the Requested Priority. If there is a deadline related to your request, please provide your requested timeline. (*)


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