MACPC NYC — Repair Intake

1

Intake Info

Intake By

Date

Time

1

Customer Information

First Name *

Last Name *

Phone *

Email

How Did You Hear About Us?

2

Device Information

Device Type *

Model / Serial

Color

3

Issue Description

Type of Issue *

💧 Water Damage

📺 Cracked Screen

🔋 Battery Issue

💾 Data Recovery

⚡ Not Charging

⌨️ Keyboard/Trackpad

🐢 Slow/Freezing

🦠 Virus/Malware

🔑 Password Issue

🔧 Other

Describe the Problem *

Urgency

🚨 ASAP

📅 Few Days

😌 Flexible

Preferred Date

Preferred Time

4

Customer Acknowledgment

DISCLAIMER: Macpcnyc is not liable for software corruption, data loss, or hardware failure during service. It is your responsibility to backup all software and data on your computer's hard drive(s) and/or any other storage devices before our agents work on your device. Macpcnyc/PCS and or its third party service provider shall not be responsible at any time for any loss, alteration, or corruption of any software, data, or files. Furthermore, WE ARE NOT responsible for items left here for 30 days from drop off date.

Customer initials acknowledging the above

5

Evaluate / Isolate (Technician)

Customer States That…

What Does the Device Tell You? (VMI)

Physical Damage Present?

💧 Liquid

📉 Dropped/Fell

🔥 Overheating

⚡ Power Issue

🖥️ No Display

🔑 Won't Boot

1.H — Hardware Repair

2.S — Software/OS

3.EO — External Only

4.E — Evaluation Only

Resolution Code(s)

1.H Hardware

2.S Software

3.EO External

4.E Evaluation

Resolution Notes

6

Authorization & Signature

By signing here, I acknowledge that computer hardware and data are inherently prone to unforeseen damage and may result in data loss. I furthermore agree to indemnify Macpcnyc Repairs from any responsibility for data loss or hardware damage while in their possession, as it is my responsibility to backup my data before bringing my device for repair.

Customer Signature *

Sign with finger or stylus

Print Name

Date Signed