pickup & delivery

PICKUP & DELIVERY REPAIR AUTHORIZATION FORM

Daniel's Gadgets Repair – Los Angeles, CA

At Daniel’s Gadget Repair, we are committed to providing professional, transparent, and secure repair services. Please review the following terms before submitting your device for service.

Checkup, estimate, diagnostics and consultation are FREE.

Contact Person *
Company Name or N/A *
Email *
Phone Number *
Pickup Address *
Delivery Address *
Preferred Contact Method *
Device Type: *
Other Device *
Brand *
Model *
Serial Number *
ACCESSORIES INCLUDED *	Bag Battery Power Charger Hard Drive Lens Memory Card
Other Accessories *
Password/Code (if required for testing): *
SERVICE REUEST: *	Diagnostic Only Estimate Only Proceed in Repair Backup / Transfer Data / File Recovery Screen Replacement Water Damage Service No Power / Not Power On Power On but Not working
Other Service Request *
Problem Description *
Customer Pickup *
Pickup Date *
Pickup Time *
Special Instructions *
PHYSICAL CONDITION AT PICKUP *	Crack/broken damage Liquid damage Missing parts No Power Physical impact With visible damage With Power but not working Visible scratches
Other Physical Condition *
DATA & LIABILITY DISCLAIMER
	Daniel’s Gadget Repair is not responsible for data loss unless data recovery service is specifically requested. *
	I understand that I am responsible for backing up my data before service unless I have requested data recovery service. *
	Devices with liquid damage, severe physical damage, or prior repair attempts carry additional risk and may become non-repairable during service. *
	Liability is limited to the amount paid for the repair service. *
FEES & ADDITIONAL COST AGREEMENT:
	I understand that pickup and delivery service may include additional fees based on distance, urgency, parking, tolls, or special handling requirements. *
	I understand that repair estimates are based on initial diagnostics and may change if additional issues are discovered. *
	I understand that storage fees may apply to devices not claimed within 30 days after notification. *
	I agree that any additional parts, labor, data recovery services, or unforeseen repair costs must be approved before work continues. *
	I acknowledge that expedited service, after-hours service, and special transport handling may incur additional charges. *
	I agree that return delivery fees, re-delivery attempts, or incorrect address fees are the responsibility of the customer. *
AUTHORIZATION:
Full Name *
Date / Time *
Digital sign by *