Company/Organization Name:
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Primary Contact Name:
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Phone:
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Email:
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I would like to:
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When do you need this information?
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What information would you like to receive?
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If you would like to request an estimate for services, please use the Estimate Request form to provide us details about your website project. |
If you need help editing your website, you can also visit our online help site: http://help.midcompweb.com/ |
This request is for:
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Would you like us to provide a cost estimate before beginning the work?
Yes
No
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When would you like this request to be completed?
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Please list URL(s), names of page(s), and/or email address(es) pertaining to this request:
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[+] Add field |
Describe your request in detail:
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Include any support documents*:
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[+] Add another file |
* File type may be one of the following: .PDF, .DOC, .DOCX., .RTF, .TXT, .JPG, .GIF, or .PNG. File size may not exceed 5MB per file. Limit is 5 files total. If you need to send files which do not meet these requirements, please email documents to support@midcompweb.com |
This issue affects: |
Single User
Multiple Users
All Customers / Users
One or More Specific Web Page(s)
Entire Website
One or More Specific Email Account(s)
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What level of urgency does this request require?
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We're sorry you're experiencing an urgent issue. In addition to completing this form, you may also call 402-933-2160 and leave a voice mail with our support team. Please include the detail requested on this form in your message so we can expedite your request. |
Please list URL(s) or names of page(s) affected (if known):
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[+] Add URL |
When you experience the issue(s), what browser software version are you using? Type of device? Operating system?
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Please list the email account address(es) affected:
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[+] Add email address |
What method are you using to access the email account(s) experiencing the issue?
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When did you first notice the issue(s)?
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Do you see or receive a specific error or alert? What step in the process do you see it?
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What factors are you aware of that may be causing or contributing to the issue(s)?
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Describe any additional details as needed:
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Attach any screen shots (if available)*: |
How do I take a screen shot?
- WINDOWS: Ctrl+PrintScrn, paste to WordPad, save file as .RTF
- MAC: Cmd+Shift+3, .PNG file saves automatically to desktop
- MOBILE: Power+Volume Decrease, file saves automatically to photo gallery Screenshot folder
- OTHER: Use a screen capture program
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(.JPG, .GIF, .PNG, or .RTF)
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[+] Add another screen shot |
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Please verify you are human: |
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