Repair Intake Form

Complete the intake form below so we can properly receive, identify, and service your equipment.

Customer Information

Equipment Being Sent In

Equipment Item 1

Item
Details

Repair Notes

Contact / Return Shipping Address

ALL RETURN SHIPMENTS WILL BE INSURED FOR FULL VALUE AND REQUIRE SIGNATURE ON DELIVERY UNLESS CUSTOMER STATES OTHERWISE.

Return Shipping Preference

By submitting equipment for evaluation, the customer acknowledges that declined, unapproved, or unrepaired equipment may still be subject to a minimum diagnostic charge equal to one hour of labor unless otherwise specified in writing.