T-CARE Service Request Form                     

Please use the following form for requesting service under your T-CARE Service Level Agreement.   If this is an emergency, please call us at 708/349-1550 and ask for T-CARE Dispatch.

Data Needed for T-CARE Request

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  1. Please provide the following TCARE Account information:

    First Name
    Last Name
    Title
    Organization
    Work Phone
    FAX
    E-mail

  2. Indicate the Incident Response Level Desired: 


  3. Enter Date of Request:

    -- mm/dd/yy

  4. Enter Time of Request:

    -- hh:mm:ss am/pm

  5. Enter Computer ID Requiring Service (if any):


  6. Please contact this person about this request:

    First Name
    Last Name
    Title
    Work Phone
    E-mail

  7. Is this a Hardware Problem Only?

    Yes No    Both (or Not Sure)

  8. Please Describe the Problem as Clearly as Possible:


  9. Select Any of the Following Special Conditions:

    Repeat Request        Specific to One User  System Wide Problem

TechNET Express Service.
© 2000 Tallgrass Systems Ltd.

Revised: February 05, 2004

Tallgrass Systems Ltd.
Network Systems Specialists
9501 West 144th Place, Suite 100
Orland Park, IL, 60462
Ph: 708/349-2212
Fax: 708/349-1353