514 E. 2nd St.
Santa Ana, CA 92701
714-550-7758
714-550-0481 FAX

Email:
info@3stageauto.com

If you need to contact us you can either call us, fax us, email us, or fill out the information form below. Thank you for visiting our site!

3 Stage Auto Collision:
514 E. 2nd St.
Santa Ana, CA 92701
714-550-7758
714-550-0481 FAX
Email:
info@3stageauto.com

Customer Information Form

Name:
Address:
City:
State:
Zip:
Phone #:
Additional
Phone #:
Email:

Vehicle Information

Make:
Model:
Year:
Color:

Insurance Information

Who is paying for the repairs?


What is the name of the Insurance company paying for repairs (if applicable)?


Would you like us to process your claim for you (if applicable)?
YES    NO

Agent's Name:
Agent's
Phone #:
Policy Number:
Claim Number:

Has the insurance company inspected the vehicle and written a damage report (if applicable)?
YES    NO

Will you need a rental car?
YES    NO

Do you have any major concerns about having your vehicle repaired? If so, please mention them below.

 

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