Please enable JavaScript in your browser to complete this form.Name *FirstLastEmail *Company *Phone *Repair DetailsRequested Repair DateModel *Serial Number *Description of problem: *Service Parts *I ConsentIf equipment is checked in for service where service parts are no longer available from manufacturer, SITECH Intermountain takes no liability. We cannot guarantee or warrant continued operation of equipment upon completion of repair. I accept these terms and acknowledge the risks.Software *I ConsentSITECH Intermountain is not liable for settings, files, or any other data loss as a result of the repair. We do our best to copy and restore this information, however, unforeseen circumstances may result during the repair. It is highly recommended all files, data and settings are backed up before equipment is checked in for service. I accept these terms and acknowledge the risks.Printed Name *PO NumberJob TitleSignature *Clear SignatureSubmit
