Phone Repair Request

Cell Phone Repair Request

Before sending phone for repair please ensure it is unlocked/no passcode.

Send phone to:

Micah Culbreath

2552 18th Street South

Suite 300

Homewood, AL 35209

Date *

Office Location *

Office Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone Type *

Phone Model *

If iPhone - 8, 11, SE, etc. If Android - Samsung S20, etc.

IMEI *

Is this phone damaged beyond repair? *

Requestor the Type

Please describe what is wrong with the device. *

Requestor *

First

Last

Requestor's Email *