In order to service your vehicle and to set up an appointment please fill out the following pages.  We will get in contact with you to set an appointment that is convenient for you. All Items in red must be filled in.
First Name: 
Last Name: 
Address: 
Address 2: 
City: 
State: 
Zip Code:  		Phone number (day): 
Phone number (evening): 
e-mail address:
Year,Make, Model of car: 

Work you want done on vehicle:
Regular Maintenance
  3 Month maintenance
  6 Month maintenance
  12 Month maintenance
  24 Month maintenance
Other Maintenance
Wheels / Tires
Rotate 4 wheels
Rotate & Balance 4 Wheels
Mount & Balance 2 Wheels
Mount & Balance 4 Wheels
Tire Repair
Alignment
Coolant Flush
Tune up
      (pre-mid-80's cars)
Air Filter
Fuel Filter
Transmission service
Differential service
4x4 Service
Steering & Alignment
Pulls right when
Pulls left when
Drifts right when
Drifts left when 		Driving
Driving
Driving
Driving 		Braking
Braking
Braking
Braking
Steering wheel vibrates, at what speed?
Play in steering wheel
Poor steering wheel return after cornering
Hard to steer
Wanders
Steering wheel off center
Tires worn:   LF   LR   RF   RR
Starting
No Crank
Normal Crank, no start
      Cold engine
      Hot engine
Slow crank, starts
      Cold engine
      Hot engine
Warning Lights, Come On 		Slow crank, no start
      Cold engine
      Hot engine
Starts then dies
Starts after sitting
Noise while starting
      Clicks
      Loud grind
Will jump start
     Which light(s): 		Recent Repairs
Recent repairs at Autotek (explain)-
Recent repairs elsewhere (explain)-
Recent fuel changes (explain)-
Additives just added (explain)-
Brakes
Brake Inspection
Pedal feels
Hard
Spongy
Low 		Soft
High
Goes to floor
Pumps Up
Braking Feel
Pulsate
Grab
Lock Up
Other 		Chatter
Drag
Pull right
Pull left
Steering Wheel shakes
Noisy
Grinding      Squealing 		Brakes work better
       when pumped
Brakes - light on
ABS light on
Brake lights don't work
Emergency Brake
      Will not engage
      Will not hold vehicle
      Will not disengage
Brake Fluid
      Fluid has been added
            in last 3 months
      Fluid has not been flushed
            in last 30,000 miles
      Needs fluid
Customer Driving Habits
Start car and immediately drive
Start car and let warm up a few seconds
Start car and let warm up a few minutes
Mostly stop & go city street driving
Mostly highway / freeway driving
Regular trips to the mountains
Average trip length:
    1 mile
    2-5 miles
    More than 5 miles
Average miles driven a week:
    less than 100 miles
    100 - 250 miles
    250 - 500 miles
    more than 500 miles

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