Submit A Claim

To Submit a Claim, please fill out the form completely and a DTRS representative will contact you shortly.

Please type your full name.

Invalid email address.

Invalid Input

Please List a Valid Contact Number

Type of Loss

Fire

Smoke

Water

Mold

Please Check All That Apply

Please list the address requiring our services.

Please List Your Name or Company

Please List Your Address

Please List Your City

Please List Your State

Please List Your Zip

Authorized Items To Pick Up In Affected Areas

Clothing

Bedding

Window Treatments

Specialty Items

Please Check All That Apply

(ie: Footwear, Plush Toys, & Accessories)

Please list any detailed instructions

Are we HOLDING this project until bill is approved?

YES

NO

Please specify

Please let us know details of your Insurance & Claim Contacts

Please List Your Insurance Company

Who Do We Contact?

What is your Agents Contact Number?

What is your Insurance Claim or Reference Number with this Loss?

List any instructions here.