Customer Service Request Form

First Name:

Last Name:

Email:

Mobile Phone:

Home Phone:

Time to Call:

Comments:

ACKNOWLEDGMENT AND CONSENT:

By checking this box I hereby consent to receive text messages and/or phone calls from or on behalf of Patriot Auto Sales or their employees to the mobile phone number I provided above. By opting in, I understand that message and data rates may apply. This acknowledgement constitutes my written consent to receive text messages to my cell phone and phone calls, including communications sent using an auto-dialer or pre-recorded message. You may withdraw your consent at any time by texting "STOP" or "HELP" for help. See our https://patriot-auto.dcs-mvc.com/privacy for more information.