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East Rockford Collision Center is moving! Please check back for our new location.
Please contact Nick Verona (Owner) @ (815) 262-0572 if you have any questions.


Request An Appointment for an Estimate

To receive the most accurate estimate possible, please fill in as much information as possible.
Your Contact Information
Name
Address
City
State Zip
Phone
Fax
Email
Vehicle Information
Year
Make
Model
Location
Insurance Information
Who's insurance is paying for repairs? Mine Theirs None - I'm paying for it myself
Have you contacted Your insurance company Your Agent No one
Have they already look at your vehicle? Yes No
Adjuster/Insurance Contact Information
Claim Number
Company Name
Name
Telephone
Fax
Email
Insurance Company
Agent Name
Telephone
Fax
Email
Your Deductible Amount is $
Do you have rental coverage? Yes No
Have you had any problems with your insurance company? Yes No
Would you like us to repair your vehicle? Yes No
Would you like us to handle your claim? Yes No
Would you like us to arrange for a Hertz Rental car to be sent? Yes No

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Rockford, Illinois
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