Lehman's Garage
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Services
Auto Body Repair
Auto Glass Repair
Service & Maintenance
Paintless Dent Removal
1 Day Bumpers
Fleet Services
Lease Return Clean-Up
Towing
Car Rentals
Locations
Bloomington
Chaska
Downtown Minneapolis
Eagan
Savage
South Minneapolis
Specials
Body Repair Status
Online Estimate
Schedule Appointment
Contact Us
Customer Survey
Calendar
Employment
Current Openings
Bloomington
Chaska
Downtown Minneapolis
Eagan
Savage
South Minneapolis
Auto Glass Appointment
Glass Repair
Location for Requested Services
*
Bloomington
Chaska
Downtown Minneapolis
Eagan
Savage
South Minneapolis
Mobile Service
Name
*
First
Last
Home Phone
Work Phone
Cell Phone
Address
*
Street Address
Address Line 2
City
Zip Code
Email
*
Preffered Method of Contact
Phone
Email
Desired Appointment Date
*
Desired Appointment Time
*
:
HH
MM
AM
PM
Vehicle Information
Year
*
Make
*
Ex. GMC
Model
*
Ex. Yukon
Vin Number
VIN Number (17 digits, located on driver’s side of the dashboard, can be read from the outside through the windshield)
Piece of Glass Damaged
*
Windshield
Door
Rear Window
Other
Other Glass Damage:
Any Additional Damage
Do you plan on using insurance?
*
Yes
No
Unsure
Insurance Company:
Policy #
Date of Loss
How did you hear about us?
Please check all that apply.
Auto Dealer
Coupon
Friend or Relative
Insurance Agent
Insurance Company
Internet Search Engine
Magazine
Radio
Repeat Customer
Towing Company
Yellow Page
Other
Which Auto Dealer?
Which Coupon?
Friend or Relative Name:
Insurance Agent Name:
Which Insurance Company?
Which Search Engine?
Which Radio Station?
Which Towing Company?
Which Yellow Pages?
Which Magazine?
Other:
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Auto Body Repair
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Service & Maintenance
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Glass Repair
