How'd We Do
Lurie Glass is committed to providing every customer with excellent service. Please complete the simple form below and provide us with any additional comments regarding your auto glass replacement experience with us.

In addition, if you are interested in joining our "Refer-a-friend" program please highlight yes. For every referral that we receive from you, you will receive a rotating $10 gift card that expresses our thank you. Some examples of the gift cards are: Wal-Mart, gas cards, and restaurants dinning cards. Remember the only way to receive your gift card is to enroll in the program.
Name   *
Invoice Number
Insurance Agent
Email   *
Phone   *
Approximate Date Of Service
Did our office staff provide you with professional service? Yes No
Did you go through Insurance? Yes No
Did our office staff answer all of your questions? Yes No
Did our technician leave your car clean? Yes No
How would you rate our technicians work?
How would you rate your overall experience with Lurie Glass?
Would you refer a friend to Lurie Glass? Yes No
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