Customer Service Claims

Submit any claims regarding your service below.

Customer Service Claims

"*" indicates required fields

Are you a Customer or Employee?*

Location Information

Department

Date*

Time*

Address*

Street Address City State Zip Code

Customer Information

Customers Name*

First Last

Customers Email*

A copy of this form will be sent to the email provided.

Customers Email*

A copy of this form will be sent to the email provided.

Customers Phone Number*

Address*

Street Address City State Zip Code

Vehicle Information

Vehicle Make*

Vehicle Model*

Vehicle Year*

Vehicle Color*

License Plate*

VIN*

Statements

Customer Statement*

Claim Approval

Approved

Denied

Company Claim Statement*

Were other vehicles involved?*

If yes, enter Name / Number / License Plate. If no, say none.

Do you have incident photos or documentation to upload?*

File Upload*

Drop files here or

Max. file size: 50 MB.

Attach any documents or pictures associated with the claim.

Submitted By*

‍‍Share the name of the individual submitting this form below.

First Last

Send A Copy District manager*

Enter your district manager's email.

A Claims Representative will be in contact via the information you provided within 72 business hours. We cordially ask to please check your spam/junk folder for any correspondences. In the interim, Super Star Car Wash neither denies or accepts any responsibility until a thorough investigation can be conducted. We appreciate your patience, and we look forward to providing you with an update on your claim. Thank you.

Super Star Car Wash | Claims Department

[email protected]