Nick's Modern IT Services Intake Form

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You can fill out this form with all your information for a quote. If you want more immediate assistance, you can text or call (845) 216-7414. Please note: I do not replace smartphone screens or laptop screens. Travel fees: FREE within 15 miles of Washingtonville NY. +$1 for every additional mile.

Name *

Phone Number *

Description of issue or services requested *

Address (If Home Service Needed, if not put remote)

What is the best time and days to reach you?

Any additional details I should know before contacting you?

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