Guitar Repair Request Form
262-267 Rashik Hazari Lane
Chattogram, Bangladesh 4203
Store TEL: l +880 1732 959 934
Please cut and paste information below into an email or doc and send back to mohammad@dogpatchmusic.com
Date of Order Request: |
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Estimated Date/Need by Date: |
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Tour/Gigs/Travel Plans: |
Notes |
SECTION I - INSTRUMENT INFORMATION
Instrument Category |
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Use Drop down menu Selection |
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Strings |
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Percussion |
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Brass |
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Wind |
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Keyboards |
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Electronic |
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Folk/World |
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Other (if other provide notes below) |
Instrument Type / Description: |
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Instrument Brand Name: |
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Instrument Model Name: |
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Instrument Serial #: |
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Purchased Origin (On-line, Store, 2nd hand) |
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Type of Ownership |
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Use Drop down menu Selection |
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Privately Owned |
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School Owned |
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Institution/Corporation Owned |
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Studio |
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Other |
SECTION II - CONTACT INFORMATION
Requestor’s First Name |
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Requestor’s Last Name |
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Name of Institution /Corporation if Applicable |
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Address Line 1 |
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Address Line 2 |
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Postal Code: |
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District Name: |
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Next to Business Entity:Near/above Building or Landmark:Other Known Entity: |
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Suite # |
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Apt # |
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Floor # |
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Telephone # Home/Primary : |
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Telephone # Mobile : |
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E-Mail Address 1: |
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E-Mail Address 2: |
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Special Instructions |
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SECTION III - REPAIR OPTIONS (Drop at the store or ship via courier)
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Select from the following options below: |
1 |
Send Instrument for Repair to our store (make this a drop down list selection) |
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Get Repair estimate before hands by providing us picture |
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Call for Approval prior to ordering or conducting repairs or if estimate changed |
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Request for shipping via courier after Repairs are made |
2 |
Drop off Instrument the Store |
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Get Repair estimate on-site (make this a drop down list selection) |
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Call for Approval prior to ordering parts or if estimate changed |
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Pick-up instrument from our store |
SECTION IV - GUITAR REPAIR & MAINTENANCE WORK AVAILABLE
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Select from the list of options below |
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Guitar Repairs |
1 |
Set-Up (nuts, saddles, intonation) |
2 |
Fret Works |
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Fret Replacements |
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Levelling |
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Crowning |
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Shaping Fret ends |
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Re-seating Fret ends |
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Bridge Re-glue |
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Repair/Replace Broken Heads |
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Repair Replace Loose Brace |
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Repair /Replace Bridge |
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Neck Reset |
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Finish/Re-finish Work |
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Replace Tuning Peg |
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Crack Repair |
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Other (Describe) |
2 |
Instrument Parts Replacement (make this a drop down list selection) |
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Strings |
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Machine Heads |
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Fret |
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Bridge |
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Pick-ups |
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Other (describe) |
3 |
Instrument Maintenance & Cleaning (make this a drop down list selection) |
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Body Cleaning, Oil Maintenance |
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Alignment |
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Tuning |
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Call for Approval prior to ordering parts or if estimate changed |
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Pick-up instrument from our store |
SECTION V – UPLOAD PICTURES OR VIDEO
1 |
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2 |
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3 |
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4 |
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5 |
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SECTION VI – PAYMENT INFORMATION
Note:
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Price listed do not include cost of replacement parts
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Any items left in the store must be accompanied by a Dogpatch Music Repair form
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Actual rates may vary and are subject to change based on part’s availability, etc.
Change in estimate/work:
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You will receive a call from Dogpatch Music Services with estimates and timeline for repairing your gear.
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If we need to order part(s) we will contact you prior to ordering and provide a revised estimate
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If the level of effort or part of the repair service estimate changed prior to the original estimate due to unforeseen cracks, defects, etc. we will contact you directly.
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We accept payment by phone with B-Kash, Credit Card (Visa, Mastercard, AMEX) or Cash-On- Delivery.