Car Accident Repair Form

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If you have had an accident and would like some help in dealing with your claim please fill in the form and we will contact you as soon as we can. If your vehicle is unroadworthy please choose no in the vehicle details section. and we will try and arrange alternative transport for you as soon as possible. If your accident was not your fault please click here.

Charles Hurst respect the privacy of our customers and as such any information given by you will only be used by Lookers, and its associated companies and will not be passed on to any other company or organisation.

Please send your details

* indicates mandatory fields
Title*
Name*
Address*
Address 2
Address 3
Postcode*
Telephone*
Email address

Make*
Model*
Registration*
Year of make*

Is your car roadworthy?*
Do you need a courtesy car?*

What is the estimate for?*
Who referred you?*
Which repair centre is closest to you?*
Insurance renewal date (optional)
What is the best time to contact you?*

For an online quote, please attach pictures of your damaged vehicle

Click here to see samples of pictures if you are not sure what to send.

Please give us any comments/further details you think may help. Third party details etc!
Submit enquiry

Contact Us: Email Charles Hurst
Click here for assistance.

Call Us: 02890 381721
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