PLEASE FILL OUT ALL INFORMATION ON THIS FORM
Trouble Ticket Input
Find your Barcode
Pediatrics BarCode Number:
Name of User Having Problems:
uNid:
Location:
Choose One
417 Wakara
419 Wakara
585
Eccles Primary Childrens Outpatient Clinics
Primary Childrens Hospital
School of Medicine
South Main Clinic
Williams
Other
Room Number:
Contact Email:
Contact Phone:
Person Submitting Ticket:
Briefly Describe Problem:
Questions, Comments, or Troubles with this page?
E-mail the Pediatrics IS Office Team.
