Miracle Auto - Appointment

Miracle Auto Painting & Body Repair

To make an appointment, simply fill out this form and submit it. We will call you back to comfirm it with you.

All information given here is kept strictly confidential and will not be sold or distributed. Please include any suggestions on how we might better serve you in the future.

   Name:
Company:
Address:
        
   City: State: Zip:
  Phone:
    Fax:
 E-Mail:

Make of Vehicle:
Year of Vehicle:
Service Desired:

Is this an insurance claim?

If yes, please specify the name of the insurance company.
        

Are you the Claiment or Insurred?
        

Description of Work or Damage:

Please include me on your E-Mail list. 

Comments or instructions:

2025 E. Rio Salado Parkway

Tempe, Arizona 85281

(480) 829-8320

E-Mail: sales@miracleauto.com.