New Customers NEW CUSTOMER REGISTRATION HiddenADMINMichelleNickKielHiddenOFFICEEssendonPascoe ValeHiddenWORK TYPEInsurancePrivateThird PartyOtherHiddenLEAD TYPEPhoneInternetWalk-InReferralHiddenACTIONTo be QuotedAwaiting Claim NumberAwaiting TP LiabilityQuoted – Awaiting AuthQuoted – Follow Up CustAuthorised – await clientAuthorised – booked inPrivate Job AuthorisedCancelled – CustomerCancelled – InsurerAssemblyPanelPaintDetailCompletedHiddenTASK DATE MM slash DD slash YYYY HiddenREPLACEMENT VEHICLE?YesNoUnsureFULL NAME* CONTACT NUMBER POSTAL ADDRESSEMAIL ADDRESS Are Your Repairs...InsurancePrivateThird PartyOtherYOUR VEHICLE DETAILSVEHICLE REGISTRATION VEHICLE MAKE VEHICLE MODEL VEHICLE YEAR INSURANCE COMPANY INSURANCE CLAIM NUMBER General Description of Damage to Your Vehicle... UPLOAD IMAGESMax. file size: 256 MB.Click to upload photos of the damage to your vehicle...OTHER PARTY (If Relevant)OTHER PARY - Name, Contact Number & AddressGeneral Description of the Damage to Their Vehicle... UPLOAD IMAGESMax. file size: 256 MB.Click to upload photos of the damage to the other party's vehicle...HOW DID YOU HEAR ABOUT US?Was it...InternetGoogle Search EngineGoogle AdFacebookOther Social MediaWord of MouthDrive Locally/Shop SignagePrevious CustomerWebsiteInsurance ReferralOtherAUTHORITY TO REPAIRI, the below signed, have authority and hereby agree to my vehicle being repaired.PLEASE SIGN:
