Check In for (Virtual) Fixit Clinic
Present your broken item to a global team of expert community repairers and get suggestions for things to try. After all items have presented we put items/participants and repairers into Zoom breakout rooms to implement the suggestions and, hopefully, fix the items.

- Do you have a computer, phone or tablet (and internet connection) that will support video teleconferencing (Zoom)?
- Can you show the problem in about five minutes?
- (Optional:) Can you have some rudimentary disassembly tools at the ready?
- Can you fill out the Report Broken Item form at http://bit.ly/brokenitemreport afterwards?
If yes: register below.

Thanks; and we look forward to seeing your smiling face at the Fixit Clinic!
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Community repairers (or wannabe repairers, "fixing families") are heartily welcome to help fix (or just observe): sign up at http://bit.ly/fixitcoachsignup
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(OUR MAIN WEBSITE: www.fixitclinic.org, see also https://www.facebook.com/FixitClinic/)
Which Fixit Clinic are you attending? *
Please re-confirm with the venue as the date approaches
Required
What are you bringing?
Add Make and Model in separate fields below if it's a manufactured item. (Fill out this form again if you're bringing multiple items.)
Your answer
Make (or Brand)
(Who's the Manufacturer?)
Your answer
Model
(look on the back or underside)
Your answer
When was it manufactured?
Typically the year you bought it (assuming you bought it new)
What's wrong with it?
Provide as much detail as you can as to how it's acting up. Did the symptoms manifest gradually or was there "an event"? Can you reproduce the symptoms reliably or is it intermittent?
Your answer
What have you tried to fix it?
e.g. have you done any web research to see if someone's had a similar problem?
Your answer
OPTIONAL, BUT HELPFUL: What does the item weigh? (in decimal lbs. please)
(e.g. "3.5 lbs" not "3 lbs. 8 ozs.") This is helps us assess our waste stream diversion impact
Your answer
Can we contact you?
No promises, but someone might contact you for more information to have a better chance of fixing your item.
Liability Waiver
In consideration for being allowed to participate in the event I hereby waive, release and forever discharge Fixit Clinic, its employees, agents and volunteers, and any others acting on their behalf, from any and all responsibilities or liability from damages or injuries of any kind to my property, anyone else's property, or to me or any other person, in my party or otherwise, as a result of my participation in this event. I hereby grant Fixit Clinic and its agents the absolute and irrevocable right and unrestricted permission to use photographs and video taken at the event.
Email address
Your answer
How did you hear about Fixit Clinic?
Your answer
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