Registration Form

sedgwick

Ready to join the fastest growing network of auto direct repair facilities in the nation? Complete Sedgwick’s registration form below and start increasing the repair volume potential for your shop.

Basic Info
Contact Details
Physical Location
Mailing Address
Repair Facility Details
Attach W9*
Office Hours
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Preferred Network Status (please update the below rates that you are willing to provide to Sedgwick customers)
Posted Rates (Normal Rates) Preferred Network status rate (Sedgwick Customer Rates)
Body*
$
$
Paint Materials*
$
$
Mechanical/Electrical*
$
$
Frame*
$
$
Body and Paint Labor*
$
$
Structural*
$
$
Aluminum Structure*
$
$
Training and Certification
Additional Equipment and Services
Additional Comments
Images

Image of the front of your repair facility*

Select image...

Internal picture of your lobby and internal shop*

Select image...
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