| Please print this and send it along with your storage media |
| Affiliate ID: |
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| Referenced By: |
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| Name: |
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| Organization: |
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| Shipping Carrier: |
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| Account Number: |
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| Manufacturer: | ---- |
Media Type: | ---- |
| Model: | ---- |
Compressed: | ---- |
| Platforms: | ---- |
Capacity: | ---- |
| # of Partitions: | ---- |
File System: | ---- |
| Redirected From: | ---- |
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Circumstances of Hard Drive Crash:
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List important files / Directories:
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Terms of Contract:
Disk Doctors Lab, Inc. (DDLI)is not responsible for any damage to the equipment in the shipping process, or during the data recovery process. DDLI is not responsible for any equipment left after 30 days. DDLI will not perform any work without the customer's approval of the quote after the initial analysis. DDLI guarantees the privacy of its customers data.
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| Agreed with terms of contract: ----
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Signature: | _________________________________________
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Date: | ________________
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