CLNW Intake Form

Completion of this form is required for service

Contact Name
Phone Phone - ### - ### ####
Email
How do you want to pay
Address Address
Street Address City State / Province / Region Postal / Zip Code
REQUIRED ITEMS

Please bring the required items listed below:
- Power Supply
- Installation disks
- Software licenses
- Password List
- Peripherals involved in problem
Issue Summary

This will be the ticket title.
Description of problem/work to be done:
Equipment/software checked in:
If necessary, may we delete all files (data and software programs) in order to re-install the operating system and make the computer functional again?

If necessary, may we delete all files (data and software programs) in order to re-install the operating system and make the computer functional again? Yes No - customer will be contacted if data loss is expected Please perform data backup prior to work. ($50)
Disclaimers

Disclaimers Customers are responsible for their own data. We take no responsibility for data loss through hardware malfunction, fire, theft, or accident. Software restoration can only be done for licensed software with customer provided software or license. Labor rate for work not included in initial service quote will be billed at $95/hr. Physical repairs will void the manufacturers warranty on your computer. Please contact manufacturer, retail store or supplemental policy if there may be a valid warranty. Any items left over 45 days from date of repair will be considered abandoned and sold to recover the cost of expenses accrued by Computer Link Northwest, LLC.
Technical Notes:

Technical Notes: Add More Details
Technical Notes Below

Add relevant technical notes below:
Device Username
Device Password
Device Security Questions
Other Accounts

Other Accounts Microsoft Google
Microsoft Login
Microsoft Password
Google Login
Google Password
Google 2FA
Other Passwords/Issues/Details for tech:
Services to be performed (Estimated Cost)

Services to be performed (Estimated Cost) Hardware Repair ($129 - ???) Software Installation ($49 per application) Operating System Installation ($129) Windows Update Install ($79) Malwarebytes ($49) Avast Antivirus ($29) Data Transfer ($79 - $129)

Prices listed are an estimates only. Depends on the amount of data, hardware costs, and time involved in the actual work.
How did you hear about Computer Link NW
Office

CLNW Intake Form

CLNW Intake Form

REQUIRED ITEMS

Technical Notes Below