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. Minor__
 

5. Nature of the problem:
   A. Locked Up__
   B. Frozen__
   C. Hung__
   D. Shot__
 

6. Is your computer plugged in? Yes__ No__
 

7. Is it turned on? Yes__ No__
 

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

9. Have you made it worse? Yes__
 

10. Have you read the manual? Yes__ No__
 

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

12. Are you absolutely certain you've read the manual? No__
 

13. Do you think you understood it? Yes__ No__
 

14. If `Yes' then why can't you fix the problem yourself?
_______________________________________________________________________
 

15. How tall are you? Are you above this line?
_______________________________________________________________________
 

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

17. If 'nothing' explain why you were logged in.
_______________________________________________________________________
 

18. Are you sure you aren't imagining the problem? Yes__ No__
 

19. How does this problem make you feel?
_______________________________________________________________________
 

20. Tell me about your childhood.
_______________________________________________________________________
 

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

22. Can't you do something else, instead of bothering me? Yes ____