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    PROBLEM REPORT FORM
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1.  Describe your problem:
    _________________________________________________

2.  Now, describe the problem accurately:
    _________________________________________________
    _________________________________________________
    _________________________________________________

3.  Speculate wildly about the cause of the problem:
    _________________________________________________
    _________________________________________________
    _________________________________________________
    _________________________________________________
    _________________________________________________

4.  Problem severity:
    a. Minor   ___
    b. Minor   ___
    c. Minor   ___
    d. Trivial ___

5.  Is your computer plugged in?  Yes__ No__

6.  Is your computer turned on?   Yes__ No__

7.  Have you tried to fix it yourself?  Yes__ No__

8.  Have you made it worse?  Yes__

9.  Have you read the manual?  Yes__ No__

10. Are you sure you've read the manual?  Yes__ No__

11. Are you absolutely sure you've read the manual?  No__

12. Do you think you understood it?  Yes__ No__

13. If 'Yes', why can't you fix the problem yourself?
    _________________________________________________
    _________________________________________________

14. How tall are you?  Are you above this line?  ____

15. What were you doing with your computer at the time
    the problem occurred?
    _________________________________________________
    _________________________________________________

16. If 'nothing', explain why you were logged in:
    _________________________________________________
    _________________________________________________
    _________________________________________________

17. Are you sure you weren't imagining the problem?  Yes__ No__

18. Do you have any independent witnesses of the problem?  Yes__ No__

19. How does this problem make you feel?
    _________________________________________________
    _________________________________________________

20. Tell me about your childhood:
    _________________________________________________
    _________________________________________________
    _________________________________________________

21. Can't you do something else, instead of bothering me?