Tel: 212-996-6125
Fax: 800-675-3967
International Fax:
+206-374-6297

Shipping Addresses:

Data Recovery Clinic
39 Broadway, 26th Floor, New York, NY 10006
Please Use Fed-Ex, UPS, or DHL

Company:

Telephone:

Address:

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EMAIL ADDRESS:

To help us better serve you and our other customers please tell us how you found us:

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INFORMATION ABOUT MEDIA FOR RECOVERY

What Type of Media: (i.e. Hard drive, RAID, etc.

Can we break the seals on the media if necessary?
___ Yes (May Void Warranty of Drive)   ____ No
 

Operating System:

File System If Known:

Manufacturer:

Model:

Number of Volumes or Partitions On Media:

Serial #:

How Much Data Was on the Media?

Purchase Date of Media If Known:

What data is the most important for recovery? Folders, Directories, and Files.  (exam. My Documents)

What media should be used to return your data?
(*Drives with over 2gb of data we REQUIRE recovering the data to another hard drive.  You may either supply one or we can supply one to you at a reasonable cost.)
___I wish to buy a hard drive. (IDE 3.5" 80gb Drive)
___DVD ROM*

___The formatted drive I have included

___Other (specify):

Situation Of Failure

The reason of Failure or In-Accessibility:

What solutions if any have already been tried on the media:

Shipping Information

Shipping Company Used:

Way Bill # or Tracking Number So We Can Track It:

Terms and Conditions

1. Authorization
· The client authorizes Data Recovery Clinic, its employees, and agents, to receive and transport this media/equipment/data to, from and between their legally registered facilities.
2. Legal Rights
· The client is the legal owner, representative, or otherwise have legitimate rights to the property and all data contained therein sent to Data Recovery Clinic.
· Any property left with Data Recovery Clinic unclaimed for 30 days, will be disposed.
3. Limited Liability
· Data Recovery Clinic shall not be liable for any claims regarding the physical functioning of equipment/media or the condition or existence of data on storage media supplied before, during or after service.
· Data Recovery Clinic is not liable for any direct or indirect damages, including loss of data, loss of media,  loss of revenue, incidental or consequential, before, during or after service.
4. Confidentiality
·  Data Recovery Clinic and its officers and employees agree to absolute Non - Disclosure of any and all information or data files supplied with, stored on, or recovered from client equipment.
5. Payment
· Payment is due in full upon completion of successful recovery, prior to release of data (whether shipped, picked up or downloaded), unless by special previous arrangement.  If we recover the data you are looking for you must pay the price quoted for the recovery.  
· We accept VISA, Mastercard, American Express, and Discover.
6. Media Warranty:
· Data Recovery Clinic gives warranty on all return media found to be Dead on Arrival (DOA) within 7 days of shipment. Any additional warranty claims must be presented to the original manufacturer. Data Recovery Clinic keeps all recovered data 7 days to insure against DOA instances.
7. Shipping:
· All shipping charges are the responsibility of the customer regardless if the data is recovered or not.
8. Data Guarantee:
· Your recovery comes with a data guarantee, such that if an accepted recovery is not as promised, Data Recovery Clinic will do everything possible to rectify the recovery or refund all or part of the recovery fees paid.


Approved By (Print):__________________________________________ Date:___________________________

Signature: X___________________________________________________