Start-A-Repair:

Receive a FREE $500 Visa Gift Card when you have your vehicle repaired with REAL AUTO BODY that you can use towards your deductible (*Offer valid on insurance claims only).

We pickup your vehicle from your home or work and return it to you once repairs are completed by one of our network collision centers.

Just fill in the form below and we will be in contact to schedule pickup! Call us at 800-705-6495 if you need help.

First Name

Last Name

Email *

Cell Phone *

Home Phone

HOME ADDRESS *

CITY, STATE, ZIP *

IS THIS THE SAME ADDRESS WE WILL BE PICKING THE VEHICLE UP FROM? *

Yes
No (If "No," Fill in the vehicle pick-up address below)

VEHICLE PICKUP ADDRESS

VEHICLE PICKUP CITY, STATE, ZIP

YEAR, MAKE, MODEL OF VEHICLE (EXAMPLE: 2018 HONDA ACCORD) *

LICENSE PLATE NUMBER *

MILAGE(ESTIMATE IS OKAY) *

INSURANCE COMPANY NAME *

INSURANCE CLAIM NUMBER *

INSURANCE CLAIM REP INFO IF AVAILABLE (NAME AND TELEPHONE NUMBER)

WHAT IS YOUR PREFERRED DATE AND TIME TO HAVE US PICK-UP YOUR VEHICLE *

HOW DID YOU FIND US? (GOOGLE, YOUTUBE, INSTAGRAM, INSURANCE AGENT, PAST CLIENT REFERRAL) *

ADDITIONAL INFORMATION (IS THERE ANY ADDITIONAL INFO WE SHOULD KNOW ABOUT OR SPECIAL INSTRUCTIONS):

DO YOU HAVE ANY DOCUMENTS TO UPLOAD? (I.E., INSURANCE ESTIMATES, PHOTOS, OTHER)

Click or drag files to this area to upload. You can upload up to 10 files.

AUTHORIZATIONS *

By checking this box you certify that you have read and agreed to the following authorizations.

I acknowledge that I am the Owner of the above-described automobile (hereinafter “Vehicle”) and that the Insurance Company and Claim Number listed above are true and correct for purposes of having the Vehicle repaired by Real Auto Body (CA BAR # 299204) and/or Real Auto Body’s Assigned Network Collision Center (hereinafter “Repair Shop”).

I acknowledge that the Real Auto Body offer of a Free $500 Visa Gift Card, that may be used towards my deductible is only available on Vehicles that are repaired by the Repair Shop and not deemed a total loss. Offer is valid on insurance claims only.