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Customer & Device Information
Customer Name
Phone Number
Email Address
Preferred Contact Method
Phone Call
Text Message
Email
Device Information
Device Type
Smartphone
Tablet
Laptop
Gaming Console
Smart Watch
Other Device
Brand
Apple
Samsung
Google
Sony
Microsoft
Nintendo
Other Brand
Model
IMEI/Serial Number
Device Condition
Reported Issue
Repair Details
Repair Type
Screen Replacement
Battery Replacement
Water Damage Repair
Software Issue
Charging Port Repair
Other Repair
Estimated Cost
$
Priority
Standard (3-5 days)
Express (1-2 days)
Same Day (if possible)
Assigned Technician
Select Technician
Alex Johnson
Sarah Williams
Michael Brown
Emily Davis
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