Precision Car Wash
Customer Concern Resolution Form
Customer Name
*
First Name
Last Name
Address
*
Street Address
Street Address 2
City
State / Province
Postal / Zip Code
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Preferred Contact Method
*
Text
Email
Call
Submission Date
-
Month
-
Day
Year
Date
Name Date
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Wash Details
Precision Car Wash Location
*
Please Select
Rome Taberg
Rome - Black River Blvd
Oneida
New York Mills
Washington Mills
Coffeen Street
Fort Drum
Washington St (Nissan)
Eastern Blvd
Clay
Central Square
Pulaski
Adams
Fulton
Camden
Car Wash Concern
*
Wash Concern
Damage Concern
Cash Dispense Error
Other
Wash Date
*
-
Month
-
Day
Year
Date
Bay Type
*
Touch Free
Soft Touch
Self Serve
Bay Number
*
(Left to Right on Entrance)
Wash Type
*
Basic
Regular
Works
Ultimate
Detailed Concern
*
Attach Receipt Image / Proof of Payment
Browse Files
Drag and drop files here
Choose a file
Cancel
of
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Wash Concern Resolution
Resolution Request
*
I would like a Wash Code for a Free Wash
I would like a Refund
Submit
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Damage Concern Resolution
Damage Review Process:
Our Customer Care team will review the photos you upload below for the reported damage.
Our Customer Care team will also pull video of your wash based on your the uploaded receipt and the information in this form to review the claim.
If necessary the Customer Care Team will arrange an appointment with the Collision Center for a licensed estimator to review the damage and determine the cause of the damage.
Vehicle Year
eg 2024
Vehicle Make
eg Ford
Vehicle Model
eg F-250
Upload Vehicle Damage Photos
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Submit
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Next
Cash Dispense Error
Cash Entered
*
Wash Cost
*
Expected Change
Change Dispensed
*
Amount Owed
Submit
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Next
Other Concerns
*
Submit
Should be Empty: