Private Client Form

First Name:(Required)

Last Name:(Required)

Email Address:(Required)

Contact Number:(Required)

Alternative Contact Number:

Address:

Device Model:

This can be the model of the device, for example;" S22 Ultra", or the model number, for example;"A1688".

Device Colour:

Fault Description:

Total price of parts required for repair:

Breakdown of parts required:

Total:

Please note that this total may change due to additional damages that are found during the repair, or due to sudden price changes. You will be notified of any changes before we proceed.

Platinum Repairs: Trustworthy Tech Repairs In South Africa

Private Client Form