Name:
Title:
Company Name:
Type of Business:
Street Address:
City:
State:
Zip Code:
Phone:
Cell Phone:
Other Phone:
Fax:
Email Address:
When is the best time to reach you?

Please fill out the appropriate section depending on the type of services you are needing.

For Troubleshooting & Repairs, click here
For Upgrades, click here
For Computer Clean-Up, click here

REPAIRS
Describe the problem you are having.
Do you think your problem is hardware or software related?

Are you part of a workgroup or network?

What operating system are you currently using?
Are you getting any error messages?
If yes and you can remember what the message said, please write it below.
Is your computer running slower than normal when it boots up or shuts down?
Do the errors seem to occur when you perform specific tasks or randomly?
When you turn on your system, do you hear any beeping noises?
Have you added any new programs lately or new updates?

If so, please list the programs or updates here:
Have you added any new hardware to your system within the last month?
If so, please list the hardware you have added here:
Do you have an antivirus program?
If yes, what is the name of the anitivirus program?
When was the last time you scanned your hard drive for viruses?
UPGRADES
What operating system are you currently using?
What do you want to upgrade?
What is the goal of your upgrade?
To make your computer run faster
To add functionality to your computer (i.e. CD-RW Drive, etc.)
System security (i.e. antivirus software)
Do you have a specific computer hardware/software component in mind? If so, which one(s):
Have you purchased the parts or the software?
COMPUTER CLEAN-UP
What operating system are you currently using?
Do you have an antivirus program?
Do you have "spam" protection for you e-mail?
What is goal of the system clean-up?
Remove unwanted programs
Check for and remove viruses
Optimize performance and security
Other, please explain.

Thank you for completing the form. It will help assess your computer service needs.


 
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