Book Virtual Assessment Book Virtual Assessment Claim # Name * Name First Name First Name Last Name Last Name Phone Number Email Address * Date Time 1112131415 : 00153045 Make of Device * Apple Samsung OtherOther Zoom assessments are only for phones and tablets that turn on and are not liquid damaged. We cannot assess Laptops or consoles remotely. Please ensure that your device is backed-up. Device Doctor is not liable for any unexpected data loss during an assessment/repair. Model Number What is the model number of the item you are claiming for? On phones and tablets, this is written in tiny font on the back cover. If you are not sure, please try give us the correct model name. Eg: iPhone 6s, Galaxy A3 2017 or Xbox One S. We need to book the correct stock for you, so it is important for us to have the right information to assist you as quickly as possible. Item Colour What colour is your item? Knowing this helps us make sure we have the right parts in stock for you. What has been damaged? Screen Back cover / housing Liquid damage Not switching on at all Additional damage / other problems experienced Liquid Damage Please can you tell us how it happened, or what type of liquid damaged your device? Additional damage / problems experienced * Please give as much detail as possible to help us assess your damaged device as quickly as possible. Any other problems? Yes No Have you experienced any other problems with your device, whether before or after the incident that resulted in your claim? Additional problems Please give as much detail as possible, including whether this was experienced before or after the incident that resulted in this claim. Additional Notes Is there anything else you would like to add? Terms and Conditions * Yes I have read, and agree to the conditions explained in the linked document, with regards to the Terms and Conditions of Platinum Repairs. For any enquiries, please contact our offices on 010 594 7588 or email us at [email protected]. Data Use Consent * Yes I have read, and agree to the conditions explained in the linked document, with regards to the use and protection of my data, in terms of the POPI act. Platinum Repairs have to comply with the new legislation and require your consent to process your data. Your data will be safe and will not be shared. Submit If you are human, leave this field blank.
