Computer Drop Off Web Form | Data Medics | Castle Rock & Denver Area

Name*
Business
Address

City, State
Zip
Primary Phone*
Secondary Phone
Email Address
Hear about us?

Make
Model

Type
Use

Client ISP
Logins
Passwords
Backup?

Client Reported Computer Symptoms:

The more detailed you are about when the issues started happening and when it happens will allow for Data Medics technicians to recreate the problems and get you a diagnosis faster. For example: ‘Computer freezes when getting onto internet’ or ‘Outlook will not open attachments from anyone with a MSN e-mail address’ or ‘downloaded a music file now computer shuts off at random times’.

Inventory of Items Left for Service:

Please list all items that you are leaving at the drop off center. Data Medics, LLC, is not responsible for any lost items which are not listed in this area. For example: ‘black leather laptop bag, Office 2007 CD, Seagate Backup Hard Drive & power adapter.’

By clicking ‘Continue,’ I approved Data Medics, LLC, of diagnosing my computer and any issues I am experiencing. I understand that a $25 trip charge will be charged to me when Data Medics, LLC, drops my computer off at the location I specify above as my address, as well as any additional charges in which I will become aware of when the diagnosis of my computer is finished. I understand that if I am within Castle Rock city limits, my $25 trips charge will be waived if I decide to approve any service with Data Medics, LLC.