Service Information Request Form

I. Contact Information

Full Name:

Organization:

Job Title:

Email:

Phone Number:

Preferred Contact Method:

 

Street Address:

 

City:

State/Province:

Postal/Zip Code:

II. Service Details

Service Type:

Service Name:

Brief Description of the Service Needed:

 

Purpose of the Service Request:

New project

Existing service modification

Troubleshooting

Information gathering

Other:

 

Specific Requirements/Needs:

 

Desired Start Date:

Estimated Duration of Service:

Estimated Duration of Service:

Number of Users/Clients Impacted:

Is this a new service or a modification to an existing service?

 

Existing Service Name/ID:

Are there any specific constraints or limitations (e.g., Budget, Technical limitations, Legal requirements)?

 
 

III. Additional Information

Estimated Budget for this Service:

 

Funding Source:

Purchase Order Number (if applicable):

Priority of this request:

Reason for urgency (if applicable):

 

Form Template Instructions

Please remove Form Template Instructions before publishing the form

 

Key Considerations:

  • Use clear and concise language.
  • Group related questions together.
  • Use required fields sparingly, only for essential information.
  • Provide help text or examples where needed.
  • Use a consistent format and branding.
 

Instructions for II. Service Details:

  • Be Specific: Avoid overly broad categories. "IT Services" is less helpful than "Network Support" or "Software Installation."
  • Group Similar Services: Use categories to organize the list and make it easier to navigate.
  • Use Clear and Concise Language: Avoid jargon or technical terms that requesters might not understand.
  • Keep it Up-to-Date: Regularly review the list and add or remove services as needed.
  • Consider Subcategories: If you have a large number of services in one category, consider using subcategories (e.g., under "IT Services," you might have "Networking," "Software," "Hardware"). This might require a more complex form design.
  • "Other" Option: Include an "Other" option with a free-text field for services that don't fit into the predefined categories. This allows you to capture requests for new or less common services.
 

Instructions for III. Additional Information:

  • Clarify "Estimated": Make it clear that the budget is an estimate and subject to change. You could add a small note like "(This is an estimate and may be adjusted based on the final scope of work)."
  • Currency: Specify the currency (e.g., USD, EUR, AUD).

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