PC Repair Drop Off
Client informationPlease completely fill out this form so we can service you better. Thank you!
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
Please enter a valid phone number.
Desired Drop off Date & Time
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Windows User ID
*
Windows User Password
*
Brief description of the problem(s) you are experiencing:
*
A Free Basic Diagnosis is provided within 2 business days (Mon-Fri)of drop off time. You will be contacted at the above phone number or email address. Please note that the free diagnosis does not include a hardware breakdown. This mostly applies to laptops however if this is needed in order to diagnose a problem you will be contacted prior with a quote before we attempt to proceed
*
Phone
E-Mail
Both
Items Being Dropped off
Laptop
Desktop
Click above if you have read and agree to the
TERMS AND CONDITIONS (CLICK LINK)
Terms and conditions
*
Yes
Your Signature
*
Please verify that you are human
*
Submit
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