IT SUPPORT TICKET
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Minutes
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AM/PM Option
Priority:
*
Low
Medium
High
Critical
Your Name:
*
Office/Client Name:
*
Email and/or Callback Number:
*
Issue type:
*
Computer Issue
Printer Issue
Phone/Internet Issues
Not Receiving Results
EMR Interface Issue
Portal Issue
Password Reset / Locked Out
Description of Issue:
Upload screenshot and/or Document:
Submit Ticket
Should be Empty: