Plan To Use Insurance? *

Yes

Not Sure

Insurance Claim Filed?

Yes

Insurance provider

Claim Number

Deductible

Insurance EOR

If you already have an estimate from your insurance, upload it here.

How to Upload Photos to Our Dent Qualification Form

Uploading photos is quick and easy! Follow these steps:

Tap the Upload Field
- Click on the photo upload section of the form.
Choose How to Upload
- Take a New Photo: Click the camera icon, snap a picture, and it will automatically upload.
- Upload from Your Album: Select a photo from your gallery.
- Please Upload the photos as requested, this way we can clearly see the panel and the damage.
Done!
- Once uploaded, the image is attached to your form.

Complete the rest of the form and submit!

If you have any issues, feel free to reach out for assistance.

Whole Panel *

Photo of the whole panel/s affected

Angle From Front *

Photo of the damage from the front looking back at about a 45 degree angle.

Angle From Back *

Photo of the damage from the back looking forward at about a 45 degree angle.

Close Up *

Close up of the dent, or areas of concern. Ex: scratch or chip in paint, small dent doesn't show in larger photo

Extra Damage Photos

Any extra photos that could help.

Vehicle Year *

Vehicle Make *

Vehicle Model *

Full Name *

Email *

Phone *

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