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“YeaWeFixThat”
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1
Customer Name
*
This field is required.
First Name
Last Name
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2
Email
example@example.com
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3
Phone Number
*
This field is required.
Area Code
Phone Number
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4
Apple iPhone
Device Model
iPhone 14 Pro Max
iPhone 14 Plus
iPhone 14 Pro
iPhone 14
iPhone 13 Pro Max
iPhone 13 Pro
iPhone 13
iPhone 12 Pro Max
iphone 12 Pro
iPhone 12
iPhone 12 Mini
iPhone 11 Pro Max
iPhone 11 Pro
iPhone 11
iPhone Xs Max
iPhone Xs
iPhone Xr
iPhone X
iPhone 8 Plus Black
iPhone 8 Plus White
iPhone 8 Black
iPhone 8 White
iPhone 7 Plus Black
iPhone 7 Plus White
iPhone 7 White
iPhone 7 Black
iPhone 6s Plus Black
iPhone 6s Plus White
iPhone 14 Pro Max
iPhone 14 Plus
iPhone 14 Pro
iPhone 14
iPhone 13 Pro Max
iPhone 13 Pro
iPhone 13
iPhone 12 Pro Max
iphone 12 Pro
iPhone 12
iPhone 12 Mini
iPhone 11 Pro Max
iPhone 11 Pro
iPhone 11
iPhone Xs Max
iPhone Xs
iPhone Xr
iPhone X
iPhone 8 Plus Black
iPhone 8 Plus White
iPhone 8 Black
iPhone 8 White
iPhone 7 Plus Black
iPhone 7 Plus White
iPhone 7 White
iPhone 7 Black
iPhone 6s Plus Black
iPhone 6s Plus White
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5
Samsung
Device Model
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6
Computer/Mobile/Other
Device Model / Make
Please Select
Please Select
Please Select
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7
Operational
*
This field is required.
Does Device Turn on.
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8
Device Issue
*
This field is required.
Please provide all information
Broken Lcd/Screen
Rear/Back Glass
Charge Port
Battery
Water Damage
Front Camera
Rear Camera
Rear Camera Lens
Speaker
Microphone
Broken Lcd/Screen
Rear/Back Glass
Charge Port
Battery
Water Damage
Front Camera
Rear Camera
Rear Camera Lens
Speaker
Microphone
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9
Customer Agreement
*
This field is required.
All electronic devices not picked up after 30 days of being notified, will be considered abandoned. Full diagnostics from technicians are subject to a $50.00 service fee which 50% will be applied to repair if you decide to repair device with us. All deposits are non-refundable. It is highly recommended that you back up information on your device prior to repair, as "YeaWeFixThat" will not be held responsible for loss of data. Repairs on your device voids factory warranty. "YeaWeFixThat" uses industry standard quality approved replacement parts and warranty's them for 60 days (excluding but not limited to cracks, scratches and water damage). There is absolutely no warranty/guarantee to water damage repairs, its only purpose if we are able to turn on said device is for the sole purpose of removing DATA. Also no warranty or Guarantee on Samsung Repairs. I HAVE READ AND AGREE TO THE ABOVE TERMS AND AUTHORIZE ''YeaWeFixThat'' TO SERVICE MY DEVICE. Thanks you for your Patronage.
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10
How did you hear about us?
Google
Yelp
Friend
Return Customer
Plaza Employe
Facebook/Twitter/Instagram
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11
Date
-
Date
Month
Day
Year
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12
Signature
*
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Clear
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