Repair Request Form

NOTE: You should receive a copy of your submission via email.
(If you use GMAIL, it may be in your spam folder.)

    Required fields are labeled - (required)

    Your Name (required)

    Your Email (required) - If you use GMAIL, check your spam folder

    Telephone (required)

    Street Address (required)

    City, State Zip (required)

    Where did you hear about us? (required)

    If Other:

    Drop-off date/time requested (required) - Call for special appointment, if not selectable

    Drop-off/House Call/Shipping (required)


    --- Equipment Information ---

    Equipment 1

    Make 1 (required)

    Model 1 (required)

    Serial 1

    Date of Purchase 1

    Date of Problem 1

    Date of Last Service 1

    Short description of problem 1: (required)


    Equipment 2

    Make 2

    Model 2

    Serial 2

    Date of Purchase 2

    Date of Problem 2

    Date of Last Service 2

    Short description of problem 2:


    Equipment 3

    Make 3

    Model 3

    Serial 3

    Date of Purchase 3

    Date of Problem 3

    Date of Last Service 3

    Short description of problem 3:


    A deposit fee of $60.00 is paid upon dropping off or mailing in equipment.

    The final repair bill will deduct the deposit fee.

    We accept Cash, Check, CashApp, or Credit Cards

    You can pay the deposit in advance here: CashApp


    (required) I have read and accept the Terms and Conditions


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    Enter Security Code (required)

    Simple Math Question (required)