Name (Required):

Device Phone Number:

Contact Phone Number:

Street Address:

City:

Email Address (Required):

Select Device (Required): (See how to identify your iPhone model)
---Apple iPhone 6Apple iPhone 6 PlusApple iPhone 6sApple iPhone 6s PlusApple iPhone 7Apple iPhone 7 PlusApple iPhone 8Apple iPhone 8 PlusApple iPhone XApple iPhone XRApple iPhone XSApple iPhone XS MaxApple iPhone 11Apple iPhone 11 ProApple iPhone 11 Pro MaxOther

Select Issue (Required)
---Cracked ScreenPoor Battery LifeCharging ProblemsAudio ProblemsOther

Passcode:

Has the device been exposed to liquid?
YesNo

Has the device been serviced previously?
YesNo

Is your phone data backed up? (ERS is NOT liable for data loss, see Terms & Conditions)
YesNo

Additional Details:

I have read and agree to Emergency Repair Shop's terms and conditions.