USAFM Computer Problem Report Questions Question Title * 1. What is your name? Question Title * 2. When did the problem occur? Date & time Date Time AM/PM - AM PM Question Title * 3. Was your problem (check all that apply): At the Family Medicine clinic Using one of the Panasonic notebook computers At USAMC At USACW Accessing from off-site Other (please specify) Question Title * 4. Identify the computer you were working at when the problem occurred. If you can see a hospital, university, or HSF ID tag with a number, please include that. Otherwise, describe the location of the computer. Question Title * 5. Was your problem related to (check all that apply): Epocrates GroupWise Hardware failure Internet access LabCorp Microsoft Office application NextGen Viewing a media file Other (please specify) Question Title * 6. Please give a description of the problem, in as much detail as possible. If you are able to capture a screenshot that would be helpful, please save it to the desktop of the computer, with a descriptive name. Done