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Crisis Connect Outside Service Form
Crisis Connect Outside Service Form
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Crisis Connect Outside Service Form
Subject
A short description to explain the nature of a ticket.
Officer Department
Crisis Connect Device Issue Type
Lost
Request New Device
Damaged
App Removal (for whole department)
App Request (for whole department)
Device Behavior Modification
Officer Assignment Change
Bad Service Area
Other
Device Type Requested.
iPhone
iPad
Clear
Number of iPhones Requested
1
2
3
4
5
Number of iPads Requested
1
2
3
4
5
Officer To Be Assigned iPhone Name 1
Officer To Be Assigned iPhone Email 1
Officer To Be Assigned iPhone Name 2
Officer To Be Assigned iPhone Email 2
Officer To Be Assigned iPhone Name 3
Officer To Be Assigned iPhone Email 3
Officer To Be Assigned iPhone Name 4
Officer To Be Assigned iPhone Email 4
Officer To Be Assigned iPhone Name 5
Officer To Be Assigned iPhone Email 5
Officer To Be Assigned iPad Name 1
Officer To Be Assigned iPad Email 1
Officer To Be Assigned iPad Name 2
Officer To Be Assigned iPad Email 2
Officer To Be Assigned iPad Name 3
Officer To Be Assigned iPad Email 3
Officer To Be Assigned iPad Name 4
Officer To Be Assigned iPad Email 4
Officer To Be Assigned iPad Name 5
Officer To Be Assigned iPad Email 5
Device Name
Labels can be found on the back of the device case. In the event the label is missing or worn off a duplicate label can be found inside the case attached to the back of the phone.
Device Phone Number
Device Serial Number
Is the device damaged?
No
Yes
I Dont Know
Is the device powered on?
No
Yes
Dont Know
Officer Currently Assigned
Officer Device Is Being Assigned To
Group/Department App Removal
Identify app that needs to be removed for the officers department. this effects all Crisis Connect devices assigned to the department requesting modification. If more than one please separate names by comma.
Group/Department App Request
Identify app that needs to be installed for the officers department. this effects all Crisis Connect devices assigned to the department requesting modification. If more than one please separate names by comma.
Device Behavior Modification Type
Identify behavior that needs to change. EXAMPLE: what is the device doing that needs to be changed? or what is the device NOT doing that needs to be added.
Nearest Cross Road or Location
Nearest location to bad service area.
Other or Unlisted Issues
Other Fields
Your name
Your first name
Your last name
Your email address
Verification Code