Customer Incident Report

Please fill out this form to the best of your ability. If you have any concerns or need assistance, please call our manager on duty @ 480-874-1234.

Date of Incident *

Arrival Time *

Departure Time *

Establishment Where Incident Occurred *

Ticket Number *

Type of Incident *

Damage Theft Vandalism Lost Key

Customer Name *

Phone Number *

Email Address *

Customer Address

Vehicle Make *

Vehicle Model *

Vehicle Year *

License Plate #

Photos of Damage (optional)

By checking this box, you acknowledge that you have filled this form out with accurate information to the best of your ability. Filling out this report does not in any way admit liability on the part of Epic Valet for the above described incident. No on-site employee is authorized to accept liability or make commitments on Epic Valet's behalf — only company management can make such determinations. Epic reserves the right to repair vehicle at Epic's preferred repair shop.