Laptop Display Issue Report Form
Please use this form to report any problems with your laptop display. Fill in as many details as possible to help us diagnose and resolve your issue quickly.
Your Name
*
First Name
Last Name
Email Address
*
example@example.com
Laptop Serial Number or Asset Tag
*
Device Model
Type of Display Issue
*
Please Select
No display / Black screen
Flickering
Lines or artifacts
Dim or dark screen
Color distortion
Cracked or physically damaged screen
Other
When did the issue first occur?
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Please describe the display issue in detail
*
Have you tried any troubleshooting steps?
Upload a photo or screenshot of the issue (optional)
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Submit Report
Should be Empty: