Service & Repair Order

Contact Name:*

Phone Number:*

Email Address (Required by Apple for repair creation):*

Billing Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Were you sent here by AppleCare Phone Support?*

Yes.No.

How Did You Hear About Us?

Model*

Please Tell Us What You've Brought:

Serial Number

Carrier

Important Service Notice: In order to provide warranty service on any Beats products, Apple requires a submission of proof of purchase. If you have a physical receipt, please be prepared to leave it with the sales associate. If you have an email or digital receipt, please send it as an attachment to newtown@capitolmac.com with your name in the subject line. We appreciate your cooperation.

Have you backed up your device to a computer or iCloud?*

Yes. I have backed up my device.No. My device powers on but has not been backed up and understand that my personal data will be lost during the repair.No. My device does not power on and understand that CapitolMac and Apple cannot retrieve the data.

Important Service Notice: In order to provide service on any iPhone or iPad, the device must be restored to factory settings. If your data is a priority, please back up your device prior to leaving your device with us. If your device does not power on, CapitolMac cannot recover your data.

Data Loss Agreement*

I understand that my iDevice will be restored during the repair process and my personal data will be lost without a backup. I agree that CapitolMac is not responsible for any data loss.

Important Service Notice: In order to provide service on an Apple Watch, it is required that the unit be unpaired from your iPhone prior to check-in. This can be done through the Watch app on your phone using the guidelines set forth in this Apple Watch support article.

Please list any additional items you will be leaving during the repair:

Accidental Damage

Does your iPhone have a damaged screen?*

No.Yes. I would like it repaired out-of-warranty for $139.00.Yes. I have AppleCare+ and would like it repaired with the $89.00 deductible.

Does your iPhone have a damaged screen?*

No.Yes. Yes. I would like it repaired out-of-warranty for $159.00.Yes. I have AppleCare+ and would like it repaired with the $109.00 deductible.

Has this phone come in contact with liquid of any form? *

Yes.No.

Problem(s) I would like diagnosed:*

Backup*

Yes, I have a complete backup.No, I do not want to back up my data and understand that CapitolMac is not responsible for data loss or corruption.I will purchase an external drive from CapitolMac and they will back up my data for free. I understand that CapitolMac will contact me if there are any issues backing up my computer's hard drive.I would like CapitolMac to backup my data to a secure server for $49.00. I understand that this backup will only remain on the server for the duration of the repair.

Accidental Damage (select all that apply):*

This computer has been in contact with liquid of some form.This computer has a cracked or damaged screen.This computer has a dented frame (Laptops only).This computer has missing or non-functioning keys (Laptops only).To the best of my knowledge, this computer has no accidental damage.

Password Information

Important Service Note: We will need your administrative password for Mac repairs. If you’d like your computer’s password to remain confidential, please change it before leaving it with us. Alternately, you can change your password to something new after you’ve received your computer back. If you do not know your administrator password, please tell us below and we will change it during the repair.

Our sales associate will provide a sheet to write down your password information. This sheet will be shredded when you pick up your device.

Password Information

Important Service Note: Apple requires the AppleID and password for all iDevice repairs. If you’d like your or AppleID password to remain confidential, please change it before leaving it with us. Alternately, you can change your password to something new after you’ve received your or iDevice back. If you do not know your AppleID password, please contact AppleCare support at (800) 275-2273.

Our sales associate will provide a sheet to write down your password information. This sheet will be shredded when you pick up your device.

I understand that:*

CapitolMac will only diagnose the issues listed above. CapitolMac is not responsible for failing to diagnose an issue that was not explicitly mentioned at check-in.CapitolMac will contact me as soon as a repair diagnosis and estimate is available. CapitolMac's goal is to turn around most repairs in 3 – 4 days.Any external case needs to be removed prior to leaving my device. If a device has stickers or a screen protector, CapitolMac does not guarantee they will be present after the repair.

Liquid Damage Waiver*

Although a liquid damaged machine may power on at the time of check-in, I understand that CapitolMac cannot guarantee continued functionality after the unit has been disassembled and diagnosed.

Liquid Damage Waiver*

Although a liquid damaged iPhone may power on at the time of check-in, I understand that CapitolMac cannot guarantee continued functionality after the unit has been disassembled and inspected.

Terms and Conditions

By signing below, I certify that I have filled out this form to the best of my ability.

CapitolMac Service Check-in

CapitolMac Service Agreement