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Watch Repair Intake
Job #:
Date:
Customer Information
Name
Phone
Email
Preferred Contact
Phone
Email
Text
Watch Details
Brand
Model
Reference #
Serial #
Case Material
Stainless Steel
Gold (Yellow)
Gold (White)
Gold (Rose)
Titanium
Ceramic
Plastic/Resin
Other
Case Back Type
Snap
Screw-down
Screwed (4 screws)
Screwed (6 screws)
Display/Exhibition
Movement Type
Automatic
Manual Wind
Quartz
Quartz Chrono
Solar
Spring Drive
Unknown
Caliber (if known)
Condition on Receipt
Running
Stopped
Intermittent
Magnetized
Rate (if running)
Power Reserve
Crystal Condition
Good
Scratched
Chipped
Cracked
Missing
Case Condition
Excellent
Good
Fair (wear marks)
Poor (dents/damage)
Crown Condition
Good
Worn
Damaged
Missing
Customer Complaint
In customer's own words:
Technician Observations
Accessories Received
Box
Papers/Card
Extra links
Extra strap
Original crystal
Other:
Service Authorization
Estimated Cost
Estimated Completion
Approved up to estimate
Call if over $
Customer Signature
Date
Free form from Back in Beat.
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