ProClean Auto Wash Refund or Call Request Form

Thank You for Your Patronage

Our goal is to provide you with the highest quality wash and outstanding customer service. If you are not completely satisfied with your experience, please fill out the form below to request a refund or to provide any feedback regarding your visit


Important Information:

  • All credit/debit card purchases are initially authorized for $10.00. The final amount will be adjusted to reflect your actual charges once posted to your account.

  • Please allow 7–10 business days for your refund to be processed. We are committed to investigating and resolving any issues you may have experienced.

  • If your concern is related to a monthly membership, please contact EverWash customer service directly at support@everwash.com or call 215-618-8808 for assistance.  

 
Sign in to Google to save your progress. Learn more
Title *
Mr, Mrs, Ms
First Name *
Last Name *
Phone Number *
Please include area code
Email Address *
Mailing Address *
Please include apartment or unit #
City *
State *
ZIP Code *
Date *
What was the date of your problem?
MM
/
DD
/
YYYY
Time *
What was the approximate time of your problem?
Time
:
Car Wash Location *
What is the location of the car wash you visited?
Machine Type *
Check what machine you had a problem with (you may select more than one)?
Required
Amount Lost *
If you lost money, how much did you lose? NOTE: Credit Card Authorization of $10.00 will drop and correct charge will debit usually within 24 hours. If charged $10.00 please check statement again in 24 hours before requesting a refund.
Payment Type *
Please select from these choices
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms