Elite Glass Gadget Repair Intake Form

Please fill out this form to start your repair process. We'll contact you to confirm details and provide a quote.

Your Information & Device Details

Full Name * Email Address * Phone Number * Device Type * Manufacturer * Device Model (e.g., iPhone 15 Pro) * Serial Number or IMEI (Optional)

Repair Details

Primary Issue * Detailed Description of the Problem * Device Condition *

Powers On Normally Powers On but has Issues Does Not Power On Unknown

Is the device currently backed up?

Yes No Not Sure

We always recommend a backup before any repair. We are not responsible for data loss.

Service Preferences

Desired Service Type

Walk-in (First Available) Schedule an Appointment Mail-in Repair

Preferred Date Preferred Time

How did you hear about us?

* I understand that a technician will diagnose my device and provide a final quote before any work begins. I authorize Elite Glass Gadget to perform the diagnostic.

html Repair Intake Form | Elite Glass Gadget

Elite Glass Gadget Repair Intake Form

Please fill out this form to start your repair process. We'll contact you to confirm details and provide a quote.

Your Information & Device Details

Full Name * Email Address * Phone Number * Device Type * Manufacturer * Device Model (e.g., iPhone 15 Pro) * Serial Number or IMEI (Optional)

Repair Details

Primary Issue * Detailed Description of the Problem * Device Condition *

Powers On Normally Powers On but has Issues Does Not Power On Unknown

Is the device currently backed up?

Yes No Not Sure

We always recommend a backup before any repair. We are not responsible for data loss.

Service Preferences

Desired Service Type

Walk-in (First Available) Schedule an Appointment Mail-in Repair

Preferred Date Preferred Time

How did you hear about us?

* I understand that a technician will diagnose my device and provide a final quote before any work begins. I authorize Elite Glass Gadget to perform the diagnostic.

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Elite Glass & Gadget


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Size

Color

Quantity

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