SCTS | Repair Intake Prototype

Prototype only: This page does not send, save, or upload customer information. Use Print to create a paper intake sheet. Do not deploy as a functioning submission portal until a secure backend and privacy notice are configured.

Customer information

Ticket number (assigned by SCTS)Full namePhoneEmailPreferred contact

Device information

Device typeManufacturer / modelSerial number (optional for initial online inquiry)Accessories includedExisting damage / physical conditionDescribe the issueBackup status

Diagnostic policy

Initial diagnostic fee: $35. Credited toward an approved completed repair. If the proposed repair is declined, the $35 diagnostic fee remains payable. No additional paid repair work without an approved estimate.

I acknowledge the diagnostic policy and understand this prototype does not authorize work or constitute a submitted request.

Do not enter passwords, PINs, recovery keys, or sensitive personal files here.