Name

Phone #

Email Address

Symptoms on your car you want corrected?

Any noises, issues, smells? Where do you see or feel them from?

When did it first happen?

How often does it happen?

Does it happen more at certain speeds or while accelerating or slowing or braking?

Are any warning lights on or have been on in recent days?

Any gauges read incorrectly?

Does the problem only happen when weather is hot or cold? Raining or dry?

Does the problem change, get worse or go away as the engine warms up?

Has this problem been diagnoses or repaired before?

Are any accessories being used when this happens? (A/C, defroster, heater fan ect..)

Does the problem change, get worse or go away as the engine warms up?

If we go for a five minute test drive with you is it likely the problem will occur?

Part(s) or Service(s) Inquiry