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If this is an Urgent or Critical Issue,
Contact The Desk Help Desk at
813-606-4345
for Immediate Assistance
Submit Your IT Support Request
Please complete the form below as fully as possible so that we can assist you.
Our support team will respond within x–y hours (business days).
Required fields are marked with an asterisk (*).
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DAS Ticket
IT Support Request
Your Name
*
Your Email
*
Affected User - If different from you
Affected User’s Email
Best Contact Phone Number
*
Extension
Best Time to Reach You (From–To)
Locations
*
Shotwell
Admin Building
Excelsior
Latino Wellness Center
JOC
Resource Center
Remote - Off Site
Other
Department
*
Accounting/Finance
Admin
Adult Medicine
Behavioral Health
Call Center
Clinica Esperanza
Dental
JOC
Lab
Medical Records
Optometry
Patient Services
Pediatrics
Referral Department
Tenn Clinic
Womens Clinic
Other
Issue Category
*
Account & Access [Password, New User, Permissions]
Email [Outlook, Mailbox, Distribution Lists]
EPIC / Citrix [Login, Session, Performance Issues]
Computer Hardware [Desktop, Laptop, Monitor Issues]
Imprivata Badge [Badge Login or Replacement]
Network & Internet [Wi-Fi, VPN, Shared Drives]
Printer & Scanner [Printing, Scanning Issues]
Peripheral Devices [Keyboard, Mouse, Webcam]
Software / Applications [Install or Application Errors]
Other [Issue Not Listed Above]
Issue Impact
e.g Single user, Multiple
Single user
Multiple users
Department affected
EPIC - Ochin Related
Other -
Descripton of Issue
*
Reboot Status
Has the device been rebooted?
Rebooted – Temporary Fix
Rebooted – No Improvement
Reboot Not Attempted
Reboot Not Required
Computer ID or Name
Attach Image of Error or Issue - Optional
Max file size (Mb): 2
Max number of files: 1
Submit Ticket
Find Your Computer ID or Name
How Do I Restart - Reboot
If this is an Urgent or Critical Issue,
Contact The Desk Help Desk at
813-606-4345
for Immediate Assistance