Call or text us at (636) 305-8288
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(636) 305-8288
Request a Virtual Estimate
Schedule an Appointment
(636) 305-8288
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Facts of Loss
Home
Facts of Loss
Name
*
First
Last
Vehicle
*
Folder # (optional)
Were you driving?
If not, who?
Phone # of driver if not you.
Approximate Speed:
Number of People in vehicle:
What Seats were occupied during the accident? Please check one:
Driver Front
Passenger Front
Driver Rear
Passenger Rear
Third Row
Was the vehicle pushed into a curb?
Did the vehicle go off road?
Were there any dash lights on prior to the accident? (i.e. - airbag, check engine, tire pressure, windshield fluid, steering, change oil, etc.)
Were there any dash lights on after to the accident? (i.e. - airbag, check engine, tire pressure, windshield fluid, steering, change oil, etc.)
Facts of Loss. Tell us what happened during the accident to better assist our Technician with the repairs:
Was anything inside the vehicle that could have caused damage to the interior? (i.e. a cup of coffee, a soda, anything heavy to damage door panels or windows, etc)
Are there any areas of damage on the vehicle NOT related to this accident?
Repair Location
*
Choose A Location
Bridgeton, MO
Columbia, MO
Crestwood, MO
Creve Coeur, MO
Ellisville, MO
Fenton, MO
Maplewood, MO
O'Fallon, IL
O’Fallon, MO
St Peters, MO
South County, MO
Webster Groves, MO
Wentzville, MO
Signature
*
Date
*
Date Format: MM slash DD slash YYYY
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