On-Site Request Form Full Name * First Name Last Name Business Name (If Applicable) Email * Phone * (###) ### #### Preferred Contact Method * Call Email Text Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Please Describe What You Would Like For Us To Do * While we take every reasonable step to protect your device and data, there is always a risk when working with damaged or failing equipment. In rare cases, an attempted repair may cause additional issues or reveal previously hidden damage. By sending your device to Heaps & Herbert Technical Integrations, you acknowledge and accept this risk. We are not liable for any data loss, worsening damage, or hardware failure that may occur during standard diagnostic or repair procedures. * I Understanding Heaps & Herbert Technical Integrations is committed to providing safe, professional, and legal technical services. To remain compliant with industry standards and local regulations, we currently do not perform the following: Running cables through walls, ceilings, or floors Modifying building infrastructure (drilling, cutting, or opening walls) Installing or distributing pirated software, operating systems, or license keys Circumventing software protections (e.g., cracking programs, jailbreaking devices) Performing electrical work that requires a licensed electrician. Performing low-voltage installations that require a licensed contractor. Unlocking phones, routers, or devices in violation of carrier or manufacturer policies. Accessing, modifying, or retrieving data without proof of ownership or authorization. Any service that would violate local, state, or federal law. * I Understand Clients are responsible for the cost of all physical equipment, components, or devices required for their service. This includes but is not limited to: Replacement parts (e.g., hard drives, RAM, power supplies) New devices or peripherals (e.g., routers, monitors, PCs) Custom PC build components Specialized accessories or hardware upgrades We do not purchase equipment using company funds under any circumstance unless the full cost is provided up front by the client. We are happy to offer recommendations and assist with ordering or installation, but all purchases must be funded directly by the client. I Understand Thank you for filling out the form! You will receive a message from us on your requested form of contact. There we will discuss more details and any questions. We look forward to working with you!