1. Describe your problem:  ______________________________


  1. Now, describe your problem accurately: _________________


  1. Speculate wildly about the cause of the problem: __________


  1. Problem Severity:
  2. Minor__     B. Minor__     C. Minor__     D. Trivial__


  1. Nature of the problem:
  2. Locked Up__     B. Frozen__     C. Hung__     D. Shot__


  1. Is your computer plugged in? Yes__ No__


  1. Is it turned on? Yes__ No__


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


  1. Have you made it worse? Yes__


  1. Have you read the manual? Yes__ No__


  1. Are you sure you’ve read the manual? Yes__ No__


  1. Are you absolutely certain you’ve read the manual? No__


  1. Do you think you understood it? Yes__ No__


  1. If `Yes,’ then why can’t you fix the problem yourself?____________


  1. How tall are you? Are you above this line? ___________________


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



  1. If `nothing,’ explain why you were logged in: ___________________


  1. Are you sure you aren’t imagining the problem? Yes__ No__


  1. How does this problem make you feel? _______________________


  1. Tell me about your childhood: _______________________________


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


  1. Can’t you do something else, instead of bothering me? Yes__ No


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