Your Name (required)

    Your Email (required)

    Your Phone (mobile) Number 123-456-7890 (required)

    Your Address (Appreciated)

    Year (required)

    Make (required)

    Model (required)

    Doors (required)
    2 door4 doors or more

    Body Style (required)

    VIN (not required but good to have required if you are going through Insurance/Fleet card)

    Licence PLATE (not required but good to have required if you are going through Insurance/Fleet card)

    Mileage (not needed but required if you are going through Insurance/Fleet card)

    Date of Damage (not needed but required if you are going through Insurance)

    Fleet Card name/number or Insurance Co.name, Policy & Claim number (not needed but required if you are going through Insurance/Fleet card)

    Service
    RepairReplacement

    Brief description of damage | Notes |
    Auto glass notes: Windshield/Door/Back/Roof/Vent/Quarter/Other (Front/Rear/Back/Driver-side/Passenger-side/Opens/Does-not-open)

    Day (Best Available) Crackmasters 105 Ave is open Monday-Friday 8-5pm
    MonTuesWedThursFriAnyday

    Drop off time (Days Available)
    8-9am (Appointment 9-noon)noon-1pm (Appointment 1-4pm)anytime

    Windshield Options
    HeatedNot Heated
    YES has a Humidity/Condensation SensorNO Condensation Sensor
    YES Has a Rain SensorNO Rain Sensor
    YES Heads Up DisplayNO HUD
    Yes LDWSNO Lane Departure Warning System or Lane Keep Assist)
    YES Electrochromatic Rearview mirrorNO Self Dimming Rearview mirror (I manually flip the switch if there are bright lights behind me)

    Other Options
    Let us know if you would like: a Shade-band (if Available) | Brands or Logos | Other
    Let us know if you have these (or other features): Forward Collision Alert | Adaptive Cruise Control | Active Braking Assist | Other

    Service Options
    YES, please! Add + BOSCH windshield wipers for $29.99/pair (preverb New Shoes, New socks!)No new wipers - I will risk scratching a new windshield with my old ones
    YES, please! Add + Aquapel glass treatment for $20 -- (a great product that last 6-9 months)No Aquapel

    How did you find Windshield Edmonton?
    Search engine (Google/Bing/Yahoo...)FacebookYelpTwitterBlogword-of-mouth