Device Status Report Form
Report the operational status and issues of a device accurately and efficiently.
Device Type
*
Please Select
Laptop
Desktop Computer
Printer
Network Equipment
Mobile Device
Other
Device Model
*
Device Serial Number / Asset Tag
*
Device Location (Building/Room/Area)
*
Current Status of Device
*
Operational
Faulty
Under Maintenance
Out of Service
Describe the Issue (if any)
Urgency Level
*
Low
Medium
High
Actions Taken or Maintenance Performed
Upload Photo of Device (Optional)
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Date and Time of Report
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Reported By (Full Name)
*
First Name
Last Name
Contact Email
*
example@example.com
Contact Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Submit Report
Should be Empty: