Computer Repair Form | CRC Tech Solutions

First name

Last name

Email

Phone

Preferred Contact Method

Phone

Email

Text

Brief Scope of Work Desired

Are You Ready to Schedule IT or Computer Repair Services?

Yes

No

If yes, please provide service address

Request Priority Level

Low

Medium

High

Critical

System Type

Desktop

Laptop

Custom Build

Other

Device Operating System

Brand / Model / Serial# of Device

Is Your Data Backed Up? CRC Tech Solutions will not be responsible for data loss.

Yes

No

Unsure

Does Your Device Have Visible Damage?

Yes

No

If Visibly Damaged, Where is the Damage? How Did it Occur?

Does hardware need replacing

Yes

No

I am unsure

N/A

Does software need replacing

Yes

No

I am unsure

N/A

Type of Service Appointment Needed?

Home Visit

Work Visit

Public Service Location

I understand CRC Tech Solutions provides mobile computer repair. A private or public service address will be required to receive services.