Employee Equipment Issue Report Form
Use this form to report problems with your assigned equipment. Please provide as much detail as possible to help us resolve your issue efficiently.
Employee Full Name
*
First Name
Last Name
Employee Email Address
*
example@example.com
Department
*
Please Select
IT
Human Resources
Finance
Operations
Sales
Marketing
Other
Equipment Type
*
Please Select
Laptop
Desktop Computer
Monitor
Keyboard
Mouse
Docking Station
Mobile Device
Other
Equipment ID or Serial Number
Location of Equipment
*
Date Issue Was Noticed
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Issue Description
*
Issue Severity
*
Critical (equipment unusable)
Major (significant disruption)
Minor (inconvenience)
Attach Photo or File (optional)
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Submit Report
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