Dear Service Customer,

To speed up your visit to our service department and more accurately complete the service you require, please take a few moments to complete this form. Thank you for your patience and assistance.


Personal Information:


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Vehicle Information:



Warranty
Extended Service Plan

Service Requested:


Mile Service

Change Oil & Filter
Lubrication
Front End Alignment
Transmission Oil Leak
Pack Wheel Bearings
Tire Rotation
Balance Front Wheels
Balance Rear Wheels
Check Brakes
Check Air Conditioner
Check Heater
Check Exhaust System
Engine Tune-Up
Check Cooling System
Service Transmission
Safety Inspection
Engine Oil Leak
Check Shocks & Steering

Drivability:


Engine Runs Erratic
Engine Will Not Start
Check for Noise in Engine
Engine Stalls When Braking
Road Test
Will Not Start When Cold
Will Not Start When Hot
Check Idle
No Start/No Starter Action
Engine Stalls When Turning
Engine Stalls
Engine Cranks/No Start
Engine Runs Turned Off
Engine Exhaust Smokes
Brakes Pull to One Side

Other Concerns/Services Needed: