Computer Repair Intake Form
First and Last Name
*
Phone Number
*
Product / Equipment Checked In
*
Brand
*
Power Supply Provided
*
Description of problem or work to be done:
*
Currently has operating system loaded?
*
Yes: Windows
Yes: Linux
Yes: OS X
No
Pre-existing Damage?
*
Yes
No
If yes, please describe:
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Signature
*
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