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Damage Report Form
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Account Owner
*
Service Address
*
Phone Number
*
Email Address
*
Please provide a brief description of the outage or network problem:
Have you observed any conditions such as downed lines, vehicle damage, or other conditions that could be dangerous?
Yes
No
Has there been digging on your property, or active construction in your neighborhood?
Yes
No
Is your outage/network issue intermittent or persistent?
Intermittent
Persistent
Issue with speed
Other
Have you restarted your home router and fiber modem?
Yes
No
If possible, can you tell if the WAN/Broadband light on your fiber modem is lit and solid (not blinking)?
Solid WAN/Broadband Light
Blinking WAN/Broadband Light
No WAN/Broadband Light
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