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Staff Access

Enter the staff password to access the intake form.

Device Intake Form

Fill in the customer and device details, then save to record the intake.

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Intake Recorded!

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Device Information

Device Type *
Brand *
Model *
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Repair Type(s) *

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Device Password / PIN

Password or PIN (optional)
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Items Provided with Device

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Notes

Any special instructions / observed issues
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Customer Information

Customer Full Name *
Phone Number *
Email (optional β€” for updates)
City
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Deposit

Deposit Type
Deposit Amount (CAD)
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Warranty

Warranty Period
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Backup

Data Backup Performed?
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Quoted Price

Quoted Price (CAD) leave blank if not quoted yet
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Device Received

Fields marked * are required