eclecTechs ISP Division
Trouble-Shooting Report Form

Please use this form to report any problems or to have an eclecTechs ISP division representive contact you about technical support. After filling out the form you will be contacted by an eclecTechs ISP division representative within 24 hours. Please make sure to fill out the form completely and give an accurate phone number and e-mail address so that you may be reached promptly. Please include if you wish to be contacted by e-mail or by telephone.

Your name:
Company Name (optional):
E-mail address (essential):
Telephone Number(s):

Please tell us a little about your system.

Computer Type:

Operating System:

Memory Amount:

Modem Type:

Modem Speed:

Please include a description about the problem you are having.
Please be as precise as possible, including times and dates if possible.

If you can't use this form, copy it, fill it out and fax it or just call us. We are here to help.

eclecTechs ISP Division Trouble-Shooting Report Form

eclecTechs ISP Division
Trouble-Shooting Report Form