PhoneRepairPOSPhone Repair Intake Form
A printable check-in form for phone repair shops. It records the device’s condition before you touch it — cracked screen, water damage, what accessories were left — and gets the customer’s written consent on passcodes, data, and liability. That one signature avoids most “it was fine when I dropped it off” disputes.
Print it (or save as PDF from the print dialog) and keep a stack at the counter. One page per device.
Free to use — no sign-up, no watermark.
Shop name
DEVICE INTAKE FORM
Date
Ticket #
Staff member
Customer name
Phone number
Email
Preferred contact (call / SMS / WhatsApp / email)
Device make & model
IMEI / Serial number
Reported issue (in the customer's words)
Condition on arrival — tick all that apply
Screen crackedScreen liftingBack glass damagedFrame bent / dentedLiquid damage suspectedDoes not power onBattery swollenButtons damagedCamera damagedPreviously repaired elsewhere
Left with the device
SIM cardMemory cardCaseCharger / cableNone
Device passcode (optional — needed for full testing)
Estimated cost quoted
I authorize the repair described above. I understand that: (1) the shop is not responsible for data loss — I am responsible for backing up my device; (2) diagnosis may reveal additional faults, and I will be contacted before any work beyond the quoted estimate; (3) devices with prior liquid damage or prior repairs carry additional risk during repair; (4) devices left uncollected for 60+ days may be disposed of or sold to recover costs.
Customer signature
Date
Tired of printing these? The free PhoneRepairPOS app for iPhone and iPad does everything this template does — tickets in 30 seconds, status tracking, customer SMS/WhatsApp updates, and PDF receipts — with no monthly fee.