Custom Jewelry Request Form

1

Full Name* This field is required.Nice to meet you!

First Name

Last Name

2

E-mail* This field is required.Thank you.

3

Contact Number* This field is required.Your cell phone number is preferred.

Please enter a valid phone number.

4

Billing Address* This field is required.No sales tax for addresses outside of NY State.

Street Address

City

State

Zip Code

Country

5

Technical Specs* This field is required.Please identify the metal type (e.g., 14k, 18k, Platinum) and any stones involved so we can calibrate our tools - specifically for laser welding or heat-sensitive gems.

6

Repair Menu - Ring ServicesSelect the structural treatments your ring requires.

Size Up Ring (Add metal)

Size Down Ring (Precision cut and join)

Shank Repair or Replacement (Fixing thin or cracked bands)

Prong Retipping or Rebuilding (Securing and protecting stones)

Re-Rounding (Correcting bent or misshapen bands)

Rebuild a crushed / mangled ring

Other

7

Repair Menu - Stones & SettingIdentify any stone security or mounting needs.

Tighten Loose Stones

Set Customer's Stones (Mounting your provided gems)

Supply & Set Missing Stones (We source and match replacements)

Professional Stone Identification & Diagnostic

Resetting / Realignment (Correcting shifted or crooked stones)

Other

8

Repair Menu - Chain & ClaspSpecify any welding or closure repairs.

Solder / Reconnect Chain (Precision laser or torch welding)

Repair or Replace Clasp

Jump Ring Soldering (Securing charms, links, or ends)

Chain Shortening or Extension

Safety Chain Installation

Other

9

Repair Menu - Earrings & SpecialtyDetail any earring conversions or specialty repairs.

Reconnect Dangle Earring

Repair or Replace Earring Posts

Convert Earring Backs (e.g., Stud to Lever-back or Clip-on)

Pearl or Bead Restringing (Knotted or unknotted)

Laser Engraving (New or additional)

Remove or Fill Existing Engraving

Brooch Pin or Catch Repair

Other

10

Repair Menu - Watch ServiceSelect the technical treatments your piece requires. If you aren't sure, select 'Full Restoration & Diagnostic' and we will perform a full structural assessment upon arrival.

Watch Battery Replacement

Full Movement Service or Replacement

Crystal Replacement (Scratch or crack repair)

Stem & Crown Repair

Link Removal or Band Adjustment

Gasket Replacement (Water resistance sealing)

Other

11

Repair Menu - Restoration & FinishingSelect the technical treatments your piece requires. If you aren't sure, select 'Full Restoration & Diagnostic' and we will perform a full structural assessment upon arrival.

Full Restoration & Refinishing (Deep buff, polish, and Rhodium plating)

Professional Ultrasonic & Steam Cleaning

Antiquing / Oxidizing Finish

Satin / Matte Finish Application

Gold Plating / Vermeil Refurbishment

Other

12

Condition & HistoryDescribe the current issue or any previous repairs. Technical history helps us treat the metal correctly.

13

Upload Photos Of Items To Be RepairedPlease upload clear, close-up photos from multiple angles. High-resolution images allow our expert jewelers to inspect for metal fatigue or prong wear before the piece arrives.

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

Images only, please.

14

Do You Need Shipping / Handling Insurance?* This field is required.Choose One

Yes, please include in quote ($2 per $100 insured)

No, I have my own jewelry insurance

Not needed - dropping off @ Motek Jewelry Studio

Waive insurance - customer bears full responsibility for any loss or damage