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Your Vehicle Model*

Diagnostics questionnaire

1. What does the car do or not do that you wish to be corrected?

2. Any strange noises, feelings, leaks or smells? Where do you see or feel them from?

3. When did it first happen?

4. How often does it happen?
---Please choose an option---AlwaysEvery 10 minutesHourlyDailyWeeklyMonthly

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

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

7. Any gauges read incorrectly?

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

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

10. Has this problem been diagnoses or repaired before?

11. Any other ways the vehicle is acting up?

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

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

You will receive a confirmation e-mail within 12 business hours of submitting this form.
No service or repairs will be performed without authorization from you. Upon initial assessment of the vehicle, you will be contacted to discuss any charges that may be required for testing and diagnosis.