American Auto Glass

American Auto Glass is proud to offer you a new Digital Fax Service that is more convenient and will save you time.

Just follow these three easy steps to make sure that we recieve your Digital Fax.
1) Fill out the form provided below.
2) Push "Send Message".
3) Once you see the Thank You Page choose to close the window or "Click here to return to the Home Page" to enter in another claim.

Required Information necessary for processing claim


Policyholder Name (Last, First)
Policy Number
Date of Loss (00/00/0000)
Deductible Amount
Type of Claim Insurance Claim Cash Claim
Cash Quote Amount
Home Phone (000-000-0000)
Other Phone (000-000-0000)
Repair
Replacement
(What glass needs replaced?)
Agency Name
Agency Contact Person
Agency Contact Phone
Vehicle Year (0000)
Vehicle Make
Vehicle Model
VIN #
Other Instructions