IT Support Request — Freedom Dental Health

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General IT Request

Password resets, account issues, general support

New Employee Onboarding

Set up accounts and access for a new team member

Computer Issue

Computer not working, slow performance, errors

Hardware Request

Monitor, mouse, keyboard, headset, webcam

Software Request

Request new software or application access

Feature Request

Suggest an improvement or new feature for a platform

Maintenance Request

Repairs, facility issues, and safety concerns

Dental Equipment Request

Request new or replacement dental equipment

Device Name (if applicable)

New or Existing Issue *

Category *

Priority *

Description *

New Employee First Name *

New Employee Last Name *

Start Date *

Position / Title *

Will they need a phone? *

Will they need email? *

PMS Systems Needed

Additional Notes

Computer Name / ID *

When did it start?

Priority *

Describe the Issue *

Hardware Type *

Quantity *

Justification *

Software Name *

Number of Users *

Reason / Justification *

Platform *

Feature Request *

Specific Location *

Scope of Project *

Priority *

1 — Not Urgent No immediate impact; schedule when convenient

2 — Low Priority Minor issue; should be addressed within the coming weeks

3 — High Priority Affects operations or patient experience; address soon

4 — Immediate Requires prompt attention; do not delay

Does this affect the professional appearance of the facility?

Select yes if this issue is visible to patients or visitors and reflects on the presentation of our practice.

Yes

Is this a safety concern?

For example: a loose ceiling tile, broken step, exposed wiring — anything that could injure staff or patients.

Yes

Use the Photos section below to attach images of the issue — this really helps Dave assess what's needed.

Equipment Name *

Manufacturer / Model (if known)

Quantity *

Est. Cost (per unit)

Contact Phone (optional)

Equipment Category *

Small Equipment Under $2,500

Large Equipment Over $2,500

Urgency *

Standard Can follow regular procurement timeline (up to 4–6 weeks)

Urgent Immediate operational or patient care need

Justification for Equipment *

Additional Notes (optional)

Screenshots (optional)

Paste or drag screenshots here

You can press Ctrl+V, drag and drop, or click to choose image files.

Up to 10 photos. Images are compressed before upload.

CC Others (optional)

Add coworkers who should also be able to view and track this ticket.

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