The is designed for the person who never has enough time to deal with car repairs. Let us help you speed things up. Fill out the following information sheet including the day and time you want to come in for your estimate. We'll preload your information into our computer. This will save you valuable time when you're in need of our services.

Customer Information:

Name
Address
City
State
Zip
Home Phone
Work Phone
Year (of vehicle)
Make (Ford, Chev, Honda, etc...)
Model (Mustang, Camaro, Accord, etc...)
Style (2 dr, 4 dr, van, etc...)



AT McLEAN'S WE CARE...

General Information
California State Law no longer requires you to get more than one estimate.

How did you hear about us?

Repeat Customer
Customer Referral
Agent Referral
Insurance Referral
Building Sign
TV Ad
Radio Ad
Drive By
Printed Ad
Yellow Pages
Other


What is most important to you when having your car repaired?

Alignment of Body
Color Match
Drive Correctly
Written Warranty
Safety
Price
Delivery on Time


Who's paying for your repair?

Your Insurance
Their Insurance
Myself
Other


Name of Insurance paying for the repair
Claim Number
Insurance Agent and Phone
Date of Loss
Has an Insurance Company Written an Estimate? YES , NO


Is this your 1st , 2nd , 3rd Estimate?


Would you like us to repair your car? YES , NO


If you were referred to us, would you please write their name
and address so we can send them a Thank You.

Name

Address





Any problems we should know about?



When would you like your estimate?
Name
Date
Time
Phone
-where we can call to confirm-