Report an ICT issue

No account is required. Provide either your email address so you can track progress later.

System Information

System *

Date Issue Began *

User & Facility Information

Designation *

Full Name (Reported By) *

Phone Number *

Email Address *

Lab Manager Full Name *

Lab Manager Email Address *

Region *

District *

Health Facility Name *

Choose a district first.

Ticket Information

Issue Type *

Impact on system use *

Issue Description *

Attachments / Screenshots You can upload up to 5 attachments. Each file must be 10 MB or smaller. If you have more than 2 screenshots, combine them into one PDF and attach that PDF.