Field Service Call Intake and Triage Form

Standardized intake form for dispatchers to capture issue type, asset details, urgency, site access, and contact information before a job enters the dispatch queue.

Submission Notice

• Brief summary of the service request
  Describe the issue in one or two sentences. Include what is happening and what is affected.
• I consent to be contacted about this service request
  By submitting this form, you consent to follow-up communication related to this request and understand the information will be used for dispatch and service coordination.

Issue and Urgency

• Issue type
• Urgency level
• Is there an immediate safety risk?
  Select Yes if there is danger to people, property, or operations.
• Describe the safety risk
  Provide a short description of the hazard and any immediate controls already in place.

Asset and Location Details

• Site / location name
  Enter the facility, branch, plant, or customer site name.
• Site address
  Include street address and any building, floor, or area details needed for arrival.
• Asset type
• Asset ID / serial number
  If available, provide the asset tag, serial number, or equipment ID. Leave blank if unknown.
• Asset model
  Enter the model only if it helps identify the correct parts or technician.

Access and Scheduling

• Site access instructions
  Include gate codes, check-in steps, parking instructions, escort requirements, or restricted areas.
• Access restrictions
  Select any known constraints that may affect dispatch or arrival.
• Preferred service date
  Choose the preferred date if the request is not urgent.
• Preferred time window

Contact Information

• Requester name
  Enter the name of the person submitting the request or the on-site contact.
• Requester role / department
  Optional: include department, team, or job role to help route the request.
• Best phone number
  Use a number where the dispatcher can reach you if clarification is needed.
• Email address
  Optional: provide an email for status updates and confirmation.
• Is the on-site contact different from the requester?
• On-site contact name
  Enter the person who can grant access or answer questions at the site.

Additional Details

• Error code or alarm message
  If the equipment displays a code or alarm, enter it exactly as shown.
• Recent changes or events
  Note any recent repairs, outages, weather events, power interruptions, or changes before the issue started.
• Photos or supporting files
  Upload photos, screenshots, or documents that help explain the issue. Maximum file size: 10 MB.