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Service Request Form - Carolina Dent PRO
1
WHAT TYPE OF DAMAGE DO YOU HAVE?
This will help us to route your request better.
DINGS & DENTS
AUTO HAIL REPAIR
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2
Dent Location(s). Select all that apply, then click next ...
*
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Front Fender
Hood
Front Door
Rear Door
Quarter Panel (rear)
Roof (top)
Trunk or Rear Hatch
Bumper Cover (Plastic)
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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'
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4
What kind of vehicle is the damage on?
*
This field is required.
Car
SUV
Minivan
Pick-up Truck
Other
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5
Do you have a photo of the dent?
If 'Yes' please note the tip on the next page...
Yes
No
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6
Image Field
If you're taking a photo of your dents.... here is a handy tip:
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7
Take Photo
If you already have a photo on your device, skip ahead to UPLOAD (next page)
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8
Please upload your photos.
Drag and drop files here
Select files to upload
Max. file size
: 10.6MB
Browse Files
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9
Please provide your First Name
*
This field is required.
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10
Please provide your Last Name
*
This field is required.
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11
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!
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12
Your contact Phone
*
This field is required.
We may need to contact you about the dent or arrange for repair.
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13
How did this dent happen?
Please provide any details about how the dent occurred (if known)
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