Equipment Drop-Off Name(*) Please let us know your name. Email(*) Please let us know your email address. Street Address Invalid Input City Invalid Input State Invalid Input Zip Code Invalid Input Mobile Phone Invalid Input Home Phone Invalid Input Work Phone Invalid Input Leaving Charger External Hard Drive USB Flash Drive Invalid Input Leaving Other Item(s) Invalid Input Description of Problem Invalid Input Steps Taken to Solve Invalid Input Critical Files/Folders to be Saved Invalid Input Additional Comments Please let us know your message. COMPUTER REPAIR & SERVICE WAIVER After submitting this form you will receive an email from PCRx with a .PDF file attached. Please print the .PDF attachment and initial/sign the required fields at the bottom of the printed document. Once initialed/signed please attach the newly printed document to the equipment being dropped off.