Calendar is loading…Powered by Booking Calendar Do you work standard work hours?*: Yes No Would you prefer to be called during or outside of work hours?*: During work hours Outside work hours Full Name*: Your Address*: Email*: Cell Phone #1*: Postal Code*: Describe your primary problem in terms of what your computer will not do, alternately in terms of what it is doing that it shouldn’t? (100 words or less)*: Describe any other problems you’re having in terms of what your computer will not do, alternately in terms of what it is doing that it shouldn’t? (100 words or less)*: How long has it been since the first time you’ve seen this problem?*: 1 day 2 days 3 days 4 days 5 days or more Dont remember How long has it been since your computer was last serviced?*: 1 week or less 1 week to 1 month 1-6 months 6 months or more How often do you experience this problem?*: Always Often Sometimes Rarely Have you upgraded, added or removed any parts from your computer in the last 3 months?*: Yes No If yes, what? (100 words or less): Have you replaced your printer, mouse, keyboard, added a fitness tracker, or other plug in devices in the last 3 months?*: Yes No If yes, what? (100 words or less): What is your daily windows username?*: What is your daily windows password? (Optional): Send