Omega Designs Online Repair Form
Customer information is considered confidential and will not be shared or distributed to any third party.
First Name:
Last Name:
Address 1:
Address 2:
City:
State/Province:
Zip/Postal Code:
Phone Number:
Fax. Number:
E-mail Address:
How Old Is Your Comp?
Processor Type/Speed:
How Much Memory?
(Not Hard Drive Space)
Operating System:
What is the problem?
Solution:
(Technician use only)
Signature:
By signing this form you give Omega Designs permission to modify your computer for the sole purpose of locating and repairing the problem stated above. You understand that Omega Designs is in no way responsible for any damage/injury you may cause to yourself, others, or property by misusing/tampering with your computer and any such actions will cause the company warranty on any parts or labor to be void.
Print and Fax to Omega Designs at (435)203-1325
If you have any problems please e-mail Shawn
swchamberlain@yahoo.com