Data recovery services submission page

FILL OUT THIS DATA RECOVERY FORM AND TELL US ABOUT THE ISSUE OF YOUR MEDIA. WE WILL PERFORM A FREE EVALUATION ON YOUR HARD DRIVE AND LET YOU KNOW HOW RECOVERABLE IT IS.

Contact Information:	All fields mark with "*" must be filled.
*Email address :**
User Type :	Personal Business
Company/Organization :
*First & Last Name :**
*Address :**
*City :**
*State :**
*Zip :**
*Telephone :**
Alternate Telephone :

How did you hear about us? :
If other, please specify :

Media Information:
*Media model :**	i.e WD3000JS
Manufacturer :	i.e Western Digital
Serial number :
*Size :**
Other accessories :	i.e power plug, externals
Operating System :
Describe what happened to media :
What has been done since media failure? :
*List files/folders/Directories to recover:**
Terms and conditions :	I (we), the undersigned authorized Datamedia recovery to evaluate my media (Disk drive, flash memory, palm, tapes, etc) upon receipt. Datamedia recovery is not liable for any damage to media in transport to and from its facilities. I (we) understand that Datamedia will try in good faith to give a fair analysis of media. No work will be done without proper authorization and acceptance of cost of service. Datamedia will conduct a free evaluation of media and will release you from any charge upon declining the service before any work is done beyond evaluation. Datamedia will abide by the law to keep your information and data confidential. Any release of data will be done upon full payment and such release to authorized person(s). Datamedia recovery will not be held liable for any lost of data, media, or any related properties. All media recovered or not will be securely dispose after case is closed for 60 days. All shipping cost will be solely client responsibility.
Agreement :	*I Agree I Do Not Agree
*Approved by :**
Date :
Please submit here :	------------------To Clear form, please press

LiveZilla Live Support

Free evaluation

Dedicated service

Comprehensive Pricing

We recover raid drives and servers

Linux, novell, unix

We recover laptop hard drives

Please fill contact info

Your email, your name, your contact number, your address. It is important that we have your email and contact number for a data recovery rep to get in touch with you.

Please fill all info about media

Model, size, Operating system, Issues encounter with drive, what you need us to recover for you.

List the most critical data.. .

Please let us know the most critical files you want to be recovered. It is important we target the critical data first before anything else, especially in a failing media.