Phone/Tablet Repair Assistance Form

1
Name* This field is required.
First Name
Last Name
2
Phone Number* This field is required.
Area Code
Phone Number
3
Can This Number Receive Text Messages?* This field is required.
Please Select
Please Select
Yes
No
4
E-mail
5
Type of Device* This field is required.
Please Select
Please Select
Phone
Tablet
Gaming Console
Other
All I need is the power cable when you bring your computer.
6
Number of Devices
That need to be repaired.
7
Name or Device* This field is required.
8
Brief Description of Issue(s)* This field is required.
9
Kind of Assistance* This field is required.You may select more than one option.
Broken Screen
Home button not working
Cracked Camera
No sound
Screen not responding
Battery
Cracked Front Screen
Cracked Back Screen
Screen Bleeding (Black lines)
Device not powering on
Other
10
Preferred Drop Off Date and Time:Please allow 24 to 48 hrs for all phone/tablet problems. Location: 2440 Texas Parkway STE 210 Missouri City TX 77489
Date
Month
Day
Year
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1
2
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Hour
00
00
10
20
30
40
50
Minutes
AM
AM
PM
11
Details
12
Would you like pickup drop off (additional $15)?* This field is required.Must be within 5 miles of 2440 Texas Parkway STE 210, Missouri City, TX 77489
YESNO
13
How did you hear about us?* This field is required.
Yelp
Nextdoor
Craigslist
Facebook
Instagram
Google
Friend/family
Other
14
DISCLAIMER:

Notice: The Tech Plug only does business with Vendors who are in lawful possession of their products. With respect to any and all goods that are listed on (1) any purchase order submitted by The Tech Plug to Vendor. or (2) any invoice submitted by Vendor to The Tech Plug, Vendor’s acceptance of payment from The Tech Plug for such goods constitutes a WARRANTY from Vendor that all goods sold to The Tech Plug have been acquired by legal means. Vendor further WARRANTS that Vendor has 100% possessory interest in the goods at the time of sale. Furthermore, Vendor WARRANTS that Vendor has the legal right to sell said goods to The Tech Plug.

"DISCLAIMER OF LIABILITY: VENDOR accepts any legal liability and responsibility for any claim made against The Tech Plug arising from the sale of goods to The Tech Plug. VENDOR will personally subrogate The Tech Plug for any and all claims made in regards to the sale of said goods, including legal costs to defend The Tech Plug or any of its principals or agents against such claims."
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