MR DING & DENT FAST QUOTE FORM

1

Tell us what Services you need:* This field is required.Please check all that apply

DENT REMOVAL (PDR)

HAIL REPAIR

WINDSHIELD CHIP

RETURNING LEASE VEHICLE SOON

Other

3

What is the approximate size of the dent or Dent(s)* This field is required.Choose all that apply. Size is from edge to edge at the longest point on the dent or crease.

1" or greater

2" to 3"

4" to 5"

5" to 7"

8" to 10"

The dent is 'bigger'

5

Do you have a photo of the dent?If 'Yes' please note the tip on the next page...

Yes

No

6

If you're taking a photo of your dents.... here is a handy tip:

7

Add a photo of vehicle or damaged areasPlease upload any photos you think would help us provide a more accurate quote.

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

8

ADD YOUR PHOTOS

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

9

Please provide your First Name* This field is required.

10

Please provide your contact Email* This field is required.We will never, ever use it for any purpose but to contact you about THIS repair. No Spam -- We promise!

11

Your Contact Phone* This field is required.We may need to contact you about the dent or arrange for repair.

Area Code

Phone Number

12

Your contact PhoneWe may need to contact you about the dent or arrange for repair.

13

How did this dent happen?Please provide any details about how the dent occurred (if known)