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CUSTOMER INFORMATION
PLEASE READ WHOLE DISCLAIMER:
ALL QUESTIONS REQUIRE ANSWERS. WE HAVE A NO RECORDING POLICY INSIDE THE SHOP, ALL CAMERAS WILL BE DISABLED. PLEASE ENSURE FUEL TANK IS FULL FOR CALIBRATION PURPOSES AND ALL PERSONAL ITEMS ARE REMOVED FROM THE VEHICLE PRIOR TO DROP OFF. PLEASE ARRIVE 5-10 MINUTES PRIOR TO YOUR APPOINTMENT, IF YOU ARE LATE YOU WILL NEED TO RESCHEDULE.
PLEASE ENSURE VEHICLE IS CLEAN FOR VIEWING, EXCEPT FOR WILDLIFE CLAIMS.
AFTER COMPLETING THIS FORM WE WILL REACH OUT TO YOU VIA TEXT FOR FUTHER BOOKINGS.
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FULL NAME
*
Your answer
FULL ADRESS
*
Your answer
PHONE NUMBER
*
Your answer
EMAIL
*
Your answer
PLEASE PROVIDE A BRIEF DESCRIPTION OF WHAT HAPPENED
*
Your answer
What part of the vehicle is damaged?
*
Your answer
VEHICLE DESCRIPTION ( YEAR, MAKE, MODEL, COLOR)
*
Your answer
ARE THERE ANY DASHBOARD WARNING LIGHTS CURRENTLY ON? IF SO, PLEASE SPECIFY.
*
Your answer
DO YOU REQUIRE A RENTAL VEHICLE DURING THE TIME OF REPAIRS?
*
PLEASE NOTE, THERE WILL BE A ONE TIME $50 FEE, AND ADDITIONAL $9 TO $13 PER DAY FOR INSURANCE.
NO
YES
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