Page 1 of 1
PC Repair Request Form
Customer Contact Info
Full Name
*
Phone Number
*
Email Address
*
Device Overview
Device Type
*
A
Desktop PC
B
Laptop
C
Custom Gaming PC
D
Mac
Brand and Model
*
Operating System
*
A
Windows 11
B
Windows 10
C
macOS
D
Linux
E
Not Sure
System Specifications
Optional - Skip if you do not know
CPU / Processor
Graphics Card / GPU
RAM / Memory Amount
Storage Type and Size
Power Supply Unit / PSU Model
Issue Description
What symptoms is the computer showing? Please be as detailed as possible.
*
When did the problem start, or did anything specific happen right before it stopped working?
*
Does the computer turn on?
*
A
Yes
B
No
C
It lights up but the screen stays black
Select the service that matches your case most
A
PC Cleaning
B
PC Component Upgrade
C
PC Component Downgrade
D
PC Component Replacement
E
Malware Cleanup
F
OS Replacement
G
Other
Important Terms & Diagnostic Consent
Terms and Conditions
*
I have read, understand, and agree to the policies available at mobilepcs.tech/docs
Submit