Appointment Form & Customer Information
Don Beck Locations *required
Customer Information
Registered Owner's Name *required
Contact Name *required
Address
Email Address
Home Phone # *required
Work Phone #
Fax #
Vehicle Information
Make of Vehicle *required
Vehicle Model
License Number *required
Transportation
Are you insured for loss of use? Yes No*required
Are you presently in a rental car? Yes No*required
Do you require alternate transportation (Courtesy Car)? Yes No*required
Insurance Information
I.C.B.C. Claims
Claim Centre Attended *required
I.C.B.C. Claim # *required
Are you an I.C.B.C. Gold Class Customer? Yes No*required
Are you an I.C.B.C. Road Star Customer? Yes No*required
Private Insurance Claims (other than I.C.B.C.)
Insurance Company *required
Private Insurance Claim # *required
Adjuster

 

 

 

PREV

NEXT

 

 

Facilities /  Locations /  Customer Service /  Customer Satisfaction / Technology / Repairing /  Painting / Completed Repair /  Guarantee /  Appointment
Courtesy Car Agreement
/  Human Resources /  Environment /  Community /  ICBC Accredited Car Shop /  Automotive Retailers Association /  BASF Product Guarantee

 

© 2000-2002 Don Beck Collision Services Ltd.
All Rights Reserved. 

Don Beck Collision Services
Toll Free in B.C.: 1-877-787-2488
Email: info@donbeck.com