Contact Information TIPS: *Get your device brand and model ready! It takes less than 2 minutes to fill in! Best experience with Desktop or Mobile landscape mode. 🙂First Name*Last Name*Email* Enter Email Confirm Email Contact NumberReferral Note:For Corporate Multiple repair, please DOWNLOAD our Corporate (Multiple) Repair template and attach to us.Accuracy of the information will directly affect the generated quoteDigital Hospital reserves the right to re-quote if the information provided are inaccurate.All Quotations are valid for 7 days unless otherwise stated.Understanding your objectives✔ What is the BRAND of your device?*✔ What is the MODEL of your device?*✔ Which is your device type?*SelectLaptop (Apple Macbook)Laptop (Windows)AIO Desktop (Windows)AIO Desktop (Apple iMac)Desktop (Windows)Tablet (Apple ipad - iOS)Tablet (Android)Tablet (Windows)Smartphone / Phablet (Apple iphone - iOS)Smartphone / Phablet (Android)Smartphone / Phablet (Others)Others✔ UPGRADE Service or have MULTIPLE UNITS to repair?*NoYes✔ Is your model a Touch screen device?*NoYesUnderstanding your problems1. Is there any LIQUID SPILLAGE or ACCIDENTAL DAMAGE?*Select belowNoYES - Liquid SpillageYES - Accidental DamageYES - Both Liquid Spillage and Accidental DamageYES - Power Surge (Burning Smell)I DO NOT KNOW✔ What type of Liquid best describe the spillage?Plain WaterSoda / Sugary DrinksCoffee / TeaOthers✔ When is the Estimated Date that the Spillage occur? Date Format: DD slash MM slash YYYY Facts: 90% of liquid spillage electronic boards can be saved if proper and correct processes are followed through after a spillage occurs! Actions to take during Spillage: 1) Unplug the mains, shut down the device. (Force shutdown if you have to) 2) Remove the battery as quickly (whenever possible). 3) If the device is a laptop, leave it upside down to reduce the risk of liquid reaching the motherboard. 4) Let the liquid dripped out as much as possible. 5) Dry the device with hair dryer as much as you can. 6) REFRAIN from switching on the device, the more times electricity runs through the spilled circuitry, the higher number of short circuitry events, thus decreasing the possibility of revival 7) Send the device to be cleaned ASAP! Impt: Sugary, acidic or alkali liquid accelerates corrosion, thereby decreasing chances of revival. 1.1 Is your device screen CRACKED?*Select belowNoYes1.2 Do you see any distortion, dark patch, colored lines on your screen?*YESNO1.3 Do you face other faults apart from cracked screen?*YESNO✔ For Accidental Damage, please describe the other damage parts (apart from screen)✔ Please attached Picture(s) of the damage parts here: Drop files here or Accepted file types: gif, jpg, jpeg, png.Please attach picture files with gif, jpg, jpeg or png format only.2. Do you observe any smoke or burning smell?*Select belowNo, I do not.Yes, I observe smoke and/or burning smell.3. Describe what happens after you press your power button?*Select belowSystem boots into Windows / OS NORMALLY -> Go to Qn 4System does not boot normally -> Go to 3.13.1 With beeping sounds?YESNOWith Display on screen?YESNOWith rebooting issues?YESNOWith Bluescreen (BSOD) ?YESNOHangs at Blinking Cursor / Folder with "!"?YESNOHang (freeze) at Windows / Apple logo?YESNO4. Do you have DISPLAY issues when you switch on your device?*Select belowNO - Screen is working fine. Please go to Question 5YES - Please ANSWER the next question 4.1I DO NOT KNOW4.1 What are your DISPLAY ERROR SYMPTOMS? (Choose one or many) Display screen is cracked or with black spots larger than 3mm Display is distorted / fuzzy / decolorized Display is flickering Others (Pls elaborate in General Remarks at the bottom)5. Do you experience AUTO SHUT-DOWN?*Select belowNO - Please go to the endYES - Please ANSWER the next question 5.1I DO NOT KNOW5.1 What are your AUTO SHUT-DOWN ERROR SYMPTOMS? (Choose one or many) Overheats Blue Screen (BSOD) Auto Shut-Down Intermittently Others (Pls elaborate in General Remarks at the bottom)6. Will you considering TRADING IN your device if it is not worth to repair or upgrade?*NOYESGENERAL REMARKS / UPGRADING or KNOWN SERVICE REQUEST:Attachment 1 (Pictures with faults or Multiple Units Repair form)Accepted file types: doc, docx, pdf, txt, gif, jpg, jpeg, png, xls, xlsx.Attachment 2 (Pictures with faults or Multiple Units Repair form)Accepted file types: doc, docx, pdf, txt, gif, jpg, jpeg, png, xls, xlsx. This iframe contains the logic required to handle Ajax powered Gravity Forms.