Schedule an auto glass repair or replacement appointment for your claimant. Fill out the form below and we will contact you shortly.

Alternatively, you may send requests via email to [email protected] for Minnesota service requests, or [email protected] for Florida service requests. You can also chat with one of our Customer Advocates by clicking the Live Assistance link located on the left side of this page. Attachments are accepted with both email requests and Live Assistance.

*If you do not receive a confirmation email or your policyholder has not been contacted within 30 minutes please call us at (888) 552-4272.

*Referrals sent after 5:00 PM weekdays or on weekends will be called in the morning on our next business day. 

The forms on this site are not supported by your browser. Please email us at [email protected], use our Live Assistance, or call us at 888-552-4272 and we will be happy to assist.

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