Elite Accident Concierge

We sincerely hope everyone is okay. Cars are fixable; people are precious.

* indicates required field

Incident Information

Is your vehicle safely and legally drivable? (no broken lights, glass, water leaks, doors operate, handles properly)*

Yes
No

Do you need towing assistance and/or does your vehicle need to be towed to our facility?*

Yes
No

Who is paying for the repairs?*

My insurance company
Their insurance company
I’m planning to pay for the repairs myself
Someone else has claimed responsibility and wants to pay for the repairs out of pocket to avoid insurance.
Undecided

Has an insurance company or an auto body shop inspected your vehicle?*

Yes
No

Will you be needing a rental vehicle?*

Yes
No

When did this accident take place?*

Are you planning on having your vehicle repaired?*

Yes
No

Do you have any concerns about the repair of your vehicle?

Personal Information

Privacy notice: your personal information will not be shared, sold or distributed to anyone outside of our company. Your privacy is important to us and the information you have provided will only be used to assist us in providing you with service to your vehicle.

Name:*

Best contact phone number:*

Email:*