Guitar Repair Request Form

Please fill out the form below, being sure to enter all required fields, which are marked with a red asterisk*. After your Repair Order Request is received, you will be contacted by phone or email to discuss the repair(s) in more detail and receive an estimate.

If you are outside of the Los Angeles area, shipping can be arranged. All shipping costs are additional, full insurance is mandatory and the responsibilty of the guitar owner. (This information will only be used to contact you regarding this Guitar Repair Request.)

Personal Information:

* indicates a required field.

Name: *

(first and last)

Email Address: *

Phone Number:*

(555-555-5555, include area code)

Best Time to Call?

9am-12pm    12pm-3pm    3pm-6pm

Guitar Information:

Guitar
Brand/Model: *

Guitar Type: *

Number of Strings: *

Please explain the type or repair(s) needed for your guitar: *

Additional Comments: