Claim request

PLEASE FILL OUT THE FORM BELOW

follow instructions for Image submission on the next page

All photos must be submitted within 7 days for claim to be considered valid

 

Name *
Name
Phone
Phone
Address *
Address
Which Bay
Soft Touch or Touch Free
Insurance Information
Name, Phone Number, Address
Damage Details
Be as descriptive as possible Ex. Wash selected, weird noises..etc.
When and Where have you previously had your vehicle washed?
Vehicle Information
This is for proper part identification. This number is always located by looking through the windshield on the drivers' side lower right corner. A picture should accompany this.