Service Request Form

Service Request

A service request is a request for information, advice, a change, addition or for a standard change (a pre-approved change that is low risk, relatively common and follows a procedure)
Project
First Name*
Last Name*
Name*

First NameLast Name
E-mail*
firstname.surname@birminghamhospice.org.uk
Phone Number:*
Please enter a valid phone number - include area code.
Please tell us the site location your requesting support at:*

ErdingtonRemoteSellyOakRetail
Which department do you belong to?
Example: IPU, H&H, PHB, People Team
Which Department/Shop are you located at?*
And your geographical location?*
Tell us your address

So we can provide support to you.
1st Line of your address:
House/ Apt Number and Street Name
City:
Which City is this?
Post Code:
Whats the postcode
What type of request do you want?:*

Information Or AdviceInstallationMove Add or Change
Category
And what service or product would the request apply to :*

ApplicationEmailsNew ProductSharepointTeamsOther
Does your request apply to:

An individualA Department
Risk rate your request:

No risk to Hospice reputation, doesn’t contravene any legal obligations and will not result in financial loss to the company.Moderate risk to Hospice reputation, doesn’t contravene any legal obligations or may result in some low financial loss to the company.Likely to cause reputational harm, contravenes our legal obligations, or highly likely to cause large financial loss to the company
Please provide a BRIEF SNIPPET of the issue:*
50 CHARACTER LIMIT
Provide further details:*
Please note you will receive an email asking you to book your availability once you have pressed submit.
Service Level Agreement
Should be Empty:

Service Request

Tell us your address

Please note you will receive an email asking you to book your availability once you have pressed submit.