Information
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Customer Account #
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Customer Name (Last, First)
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Conducted on
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Tech Name
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Office
- Orlando
- Lakeland
- Ocala
- Port St Lucie
- Jacksonville
- Gainesville
- Tallahassee
- Ft Myers
- Tampa
Tech Information
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Is this reporting a pre-existing damage or damaged caused while onsite?
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What is the pre-existing damage?
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****All photos need to be stored on mobile device for 72 hours ****
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Photo of Damage (1 Pull back of room/exterior)
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Photo of Damage (Pull back of damage)
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If TV/Personal Property photo required of branding/item info or photo of Damage (Close up photo of Damage angle #1)
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Photo of Damage (Close up photo of Damage angle #2)
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Photo of Damage ( Close up photo of Damage angle #3)
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What is the damage that occurred while onsite?
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Is this a NLOS mounting damage?
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Which orbitals had NLOS?
- 61.5
- 72.7
- 110
- 119
- 129
- 118.7
- 107 (Hughes)
- 97 (Hughes)
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What is the approximate size of the damage? (inches/feet, or compare to something available ex: id badge)
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Who was on site when damage happend?
- Customer
- Husband
- Wife
- Other
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Who was on site?
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Did the customer walk through occur?
- Yes
- No
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What action or inaction caused this damage? (Root Cause)
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****All photos need to be stored on mobile device for 72 hours ****
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Photo of Damage (1 Pull back of room/exterior)
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Photo of Damage (Pull back of damage)
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If TV/Personal Property photo required of branding/item info or photo of Damage (Close up photo of Damage angle #1)
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Photo of Damage (Close up photo of Damage angle #2)
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Photo of Damage ( Close up photo of Damage angle #3)
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Email information to manager and drsrm@drsinstall.com
