SPRUCES Equipment Repair Intake Form

Customer Full Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Preferred Contact Method
What Equipment Needs Service/Repair?
Equipment Make
Equipment Model
Equipment Serial Number (if available)
Equipment Year of Manufacture
Date Issue Was Noticed

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Describe the Equipment Issue/Problem
Symptom Examples: Won't Start. Starts Then Dies. Runs Rough. Fuel Leak. Oil Leak. Blades Won't Engage. Drive Issue. Battery Issue. Unknown
Upload Photo or Video of the Issue (optional)

Cancelof
Service Requested

Other
Equipment Operational?
Mobile Service: Gate or Access Instructions (if any)
Best Time to Contact You
I authorize SPRUCES Equipment Repair to diagnose and perform repairs on my equipment
I understand estimates may change if additional issues are discovered during repair
I understand the $50 diagnostic fee may apply even if repairs are declined
I understand SPRUCES Equipment Repair is not responsible for pre-existing damage, hidden defects, or failures unrelated to requested repairs
How Did You Hear About SPRUCES?
Signature agreeing to terms and service conditions
Special Instructions or Notes
Please verify that you are human
Should be Empty: