Repair Bench
Mobile Device Service & Repair
BOOKING FORM (CUSTOMER INTAKE) — PAGE 1 OF 2
Ph: (02) 0000 0000
demo@repairbench.com.au
https://www.repairbench.com.au
ABN: 00 000 000 000
Job Reference
Job / Ref No.
D-1008
Date Received
08/06/2026
Time Received
09:31
Assigned Technician
Demo Owner
Est. Completion
11/06/2026
Customer & Device Information
First Name
Tom
Last Name
Fletcher
Date of Birth
OS Version
HOS 18.1
Mobile Phone
0431 880 472
Alt. Phone
Email Address
tom.fletcher@example.com
Network / Carrier
Street Address
9 Enmore Rd
Suburb
Newtown
State
NSW
Postcode
2042
Brand / Make & Model / Series
Nintendo Switch OLED
How Did You Hear About Us?
Demo seed
Colour
White
Storage
64GB
Passcode / PIN
Device Type
Gaming Console / Device
IMEI (dial *#06# or Settings › About › Status)
Serial Number
XKW10044556677
Device Condition on Arrival
Component OKMinorMajorN/FN/A Component OKMinorMajorN/FN/A
Back Cover / Body Buttons / Controls
Charging Port / USB
Condition Notes / Additional Damage Observed
Accessories Received
USB-C / Lightning Cable
Power Adapter / Plug
Protective Case
Screen Protector
SIM Card
Memory / SD Card
Earphones / AirPods
SIM Eject Tool
Fault Description & When Does Fault Occur?
Fault Description / Issues Reported by Customer
Fell in a pool. Powers on to a black screen, no charge, corrosion visible on the board.
When Does Fault Occur?
☐ Always
☐ Intermittently
☐ After Charging
☐ After Drop
☑ After Liquid
Customer Authorisation & Disclaimer
By signing below I confirm: (1) I am the owner or am authorised to act on the owner's behalf; (2) I authorise the business to inspect, diagnose, and provide a written repair quote; (3) I am solely responsible for backing up all data — no liability is accepted for data loss during service; (4) Repairs will NOT proceed without my authorisation of the quoted price; (5) A diagnostic/assessment fee may apply if a quoted repair is declined after inspection; (6) Devices uncollected after 60 days may be recycled or disposed of. Diagnostic fee of $82.50 applies if quoted repair is declined. Devices uncollected after 60 days may be disposed of. All prices include GST. 30-Day Parts & Labour Warranty.
Customer Signature (Intake)
Signature
Print Full Name
Tom Fletcher
Date
08/06/2026
Contact Preference: ☐ Phone ☐ SMS ☑ Email ☐ In-Person    Max. Spend: $___________    Repairs will NOT proceed without written or verbal approval.
Collection Sign-off — completed when the device is collected
Customer Signature (Collection)
Received in good order
I confirm I have collected my device and that I am satisfied with the work performed. I have inspected the device and accept it in good working order.
Date
Repair Bench
Technical Report & Job Completion
PAGE 2 OF 2
Ph: (02) 0000 0000
demo@repairbench.com.au
Job Reference (Carry Forward from Page 1)
Job / Ref No.
D-1008
Device
Nintendo Switch OLED
Customer Name
Tom Fletcher
Date
01/10/2026
Diagnostic Findings (Technician Use Only)
Root Cause: ☐ Physical / Impact Damage ☑ Liquid / Water Damage ☐ Software / Firmware Issue ☐ Battery Failure ☐ Port / Connector Fault ☐ Component / PCB Fault ☐ Manufacturer Defect ☐ Customer Error ☐ Unknown / Undetermined
Parts Required
Part / Component Description Part Number QTY Unit Cost ($) Line Total ($)
 
 
 
PARTS SUBTOTAL: $0.00
Labour & Service
Service / Repair Performed Duration (hrs) Hourly Rate ($) Total ($)
Diagnostic & liquid-damage assessment 0.50 95.00 47.50
LABOUR SUBTOTAL: $47.50
Cost Summary (All Prices Include GST)
Parts Subtotal (inc. GST)$ 0.00
Labour Subtotal (inc. GST)$ 47.50
TOTAL AMOUNT DUE$ 47.50
Repair Authorisation (Customer to Complete)
Having reviewed the quote above, I hereby authorise:
☐ APPROVE REPAIR
Proceed with the full repair at the quoted price above.
☐ DECLINE REPAIR
Return device without repair (diagnostic fee may apply).
☐ PARTIAL REPAIR
Proceed only with: ________________________
Customer Signature (Repair Authorisation)
Print Full Name
Tom Fletcher
Date / Time Authorised
Verbal / Phone Auth: ___________________________ Authorised By: ___________________________ Staff Member: ___________________________
Quality Check & Technician Sign-Off
QC Checklist — Tick all items completed:
Device powers on normally
Reported fault fully resolved
Charging port / cable tested
All physical buttons functional
Wi-Fi / network connectivity tested
Accessories returned to customer
Final clean & inspection done
Notes:
Technician Signature
Demo Owner