Welcome to the National Coverage Mobile Care repair submission form. Submit the form using the "print" button at the bottom. Please print this form and include a printed copy with your device. Make sure to properly package your device to protect it from further damage. If you do not have coverage, don't worry, we have you covered! The system will recognize your device does not have coverage. You will then be given the opportunity to submit a form to have us repair it for you, and be invoiced for the repair. Once we receive your device, we try very hard to have it turned around and shipped back within a week's time. We look forward to working with you!