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To be considered, the below form and all requested photos must be submitted within 7 days of the wash in question. Please allow 3-5 business days for us to review this information.

First Name

Last Name

Phone

Please select location

What wash did you purchase?

Time of the incident

Date of the incident

Please Provide Your Vehicle Information
Vehicle Make/Model

Vehicle Year

Vehicle Color

Vehicle License Plate #

Vehicle Vin # (This is for part identification)

Please provide a description of the incident (Please be as descriptive as possible)

Please provide any images you maybe have of the incident

Claims

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have any questions?

Company

Locations

Claims

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