Create Trouble Ticket

Contact Information

Name*

Company*

Primary Email*

Alternate Email

Primary Phone Number*

Alternate Phone Number

Ticket Information

Internal Trouble Ticket (if applicable)

Previous Trouble Ticket # from CCI (if applicable for the same trouble)

Carrier Affected (one trouble ticket per carrier)*

Type of Trouble*

Description of Trouble:

Circuit ID(s) affected: (very important if applicable)

Address of installation for circuits affected:

Call Examples: (Originating number, Terminating number, time, time zone) *more than one is most helpful*

Select Date: (when first manifest)