Device Repair Form

Device Repair Form

Please fill out this form to reach us with your questions or concerns.
Full Name*

First NameLast Name
Email Address*
example@example.com
Phone Number*
+44 XXXX XXXXXX or 0XXXX XXXXXX
Device Type*
Problem Description*
PhoneEmailNo Preference
Preferred Collection Date*

DayMonthYear
Date
Hour MinutesAM/PM Option
Device Collection Address*

Street Address

Address 2
CityState / ProvincePostcode
Collection Fee – £30

This covers the time and travel to collect your device and carry out an initial assessment.

If you choose to go ahead with the repair, this £30 fee will be deducted from your final repair cost.

If you decide not to proceed after the diagnosis, there is no further charge, and your device will be returned.
YesNo
Lead Source
Ticket Subject
Assigned To
Queue
Priority
Should be Empty: