TELOS Customer Solutions Resolution Form

Date/Time

Month Day Year Hour Minutes AM/PM Option
TELOS Customer Service Support Inquiry

Please provide the following information to expedite the handling of your request. Note: the more info you can provide the faster our Service Representatives can address your concern. We appreciate your patience and business and will strive to deliver the best service possible in the short resolve time.
Priority

High Regular Low URGENT!
Service Request Type *
Company Contact Information

Please input as much information you can to expedite ther retrival of your account and to assit the Support team in your Account Retrieval. Thank you.
Company Name *
Full Name *

First Name Last Name
Preferred Response Option? *

Phone Email
Phone Number

Area Code Phone Number
Email *
example@example.com

Sales and Contract Inquires

Please provide your contact information and a Sales Team Member will respond within 48 hrs.
Inquiry? *
Inquiry Detail: *

General Customer Service & Support Inquiry

This section is to assist with order submissions, users assistance, and any other area support is needed.
User ID:
Please provide for assistance on user specific request or to look up account.
User Role
File Number
When Applicable
General Service Request Question:

Billing and Usage Report Support Detail

Please provide the Detail Below to Assist in routing your request to the appropriate support group.
Billing/ Usage Question:
Invoice No.
Invoice Upload

Browse Files
If you have a copy of the Invoice in question please upload or provide invoice #. Cancel of

Technical Support and Upload Data Support

Describe the issue, please provide as much information and error codes for expedited resolution.
System Performance Issues User Error Messages Batch Upload Errors
Upload Screenshot

Browse Files
**If Available **To expedite the resolution of the issue, a screen shot of the error will help our Technician resolve. Cancel of
General Technical Support Request:

Setup and Add-on Assitance

We are here to help with Users requests, Beneficiary Needs, Additional Service activated
If you need need to Add or Change a User to the system or add a New Beneficiary, CLICK HERE.

For all other requests, please complete the information below and we will get back to you in 24 hrs.
Request Type

Product Activation Setup Issues New Access Questions
Request Details
Should be Empty:

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TELOS Customer Service Support Inquiry