Intake & Service Agreement

Customer Details

Full Name *

Phone Number *

Email Address *

Device Information

Device Type *

Color

IMEI / Serial Number

PIN / Passcode *

Description of Assumed Issue / Repair Request *

Initial Device Diagnostics Checklist

Diagnostic Point	Status / Assessment (Select One)
Device Turns On?	YES NO CT N/A
Picture Clear?	YES NO CT N/A
Touch / Face ID Working?	YES NO CT N/A
Front Glass Cracked?	YES NO CT N/A
Volume Button Working?	YES NO CT N/A
Warped Back?	YES NO CT N/A
Back Cracked?	YES NO CT N/A
Able to Call?	YES NO CT N/A
Speaker Phone Working?	YES NO CT N/A
⚠️ When testing Speaker phone, make sure all operational component speakers functions cleanly.
Receive Calls?	YES NO CT N/A
Text Out?	YES NO CT N/A
Receive a Text?	YES NO CT N/A
Front Camera Working?	YES NO CT N/A
Rear Camera Working?	YES NO CT N/A
Device Backed Up?	YES NO CT N/A
Notice: A $20 fee applies to assist with data backups prior to device repair execution.
Does It Charge?	YES NO CT N/A
Was It Worked On Before?	YES NO CT N/A
Any Liquid Damage?	YES NO CT N/A

Estimated Battery Health Capacity:

Terms & Conditions Legal Agreement

1. Repair Authorization

I authorize e Mobile Repair Service to perform repair work on my Cellphone, Tablet, Watch, or Computer. I understand that the technicians will conduct a diagnostic to identify the issues and perform the requested service.

I authorize and agree to the diagnostics & repair terms. *

2. Risk of Data Loss

DATA WARNING: Repairing electronic devices can occasionally result in complete or partial data loss. e Mobile Repair Service is not responsible for the loss of any data, photos, contacts, configuration profiles, or software ecosystems. It is the customer's sole responsibility to back up their device prior to processing diagnostics.

I acknowledge the data loss warning and accept liability. *

3. Warranty & Water Resistance

I understand that manufacturer third-party repair guidelines void active primary warranties (Apple, Samsung, etc.). Devices originally built with water-resistant elements may permanently lose performance integrity during disassembly. e Mobile Repair Service does not guarantee liquid seal depth ratings post-repair.

I accept the structural warranty adjustments. *

4. Hidden Damage & Diagnostics

Devices subjected to severe physical shock, impact drops, or internal moisture tracking may contain highly brittle structural tracing tracks. Disassembly can surface hidden faults or cause complete mechanical failure on pre-compromised logic frames. e Mobile Repair Service assumes zero liability for latent internal flaws surfaced under routine device testing procedures.

I accept potential hidden fault diagnostics visibility rules. *

5. Parts & Component Warranties

Our workshop fits high-grade premium modular components. Unless otherwise specified on checkout documentation, component builds contain a 30-Day performance warranty protecting exclusively against manufacturer hardware defects. Evidence of subsequent physical fracture, frame stress, or liquid lines invalidates this protection coverage instantly.

I accept the 30-Day limited parts warranty criteria. *

6. Abandoned Property Policy

Any electronic equipment unit or accessory left uncollected in our storage facilities for more than thirty (30) calendar days from official service completion updates or repair evaluation logging will be labeled as permanently abandoned property. e Mobile Repair Service reserves standard disposal, component recovery, or resale rights to cover inventory service fees.

I understand and accept the 30-day storage abandonment terms. *

Digital Signature Authorization

Draw Signature with Apple Pencil or Touch *

By signing inside the box above, you acknowledge that you are providing a binding electronic authorization matching standard physical ink sign-off forms.

Date of Agreement Submission *