On-Line Drivability Questionnaire

On-Line Drivability Questionnaire


Your Contact Information
Full name:
Daytime phone:
Evening phone:
Email address:

Your Vehicle Information
Year:
Make:
Model:
Engine size:

Service Information
What are the symptoms? In your own words, describe exactly what the vehicle is doing.
When do the symptoms occur?	Engine is cold Accelerating Cruising Engine is hot Decelerating Applying brakes lightly Hot outside Cold outside Applying brakes heavily Other
How often do the symptoms occur?	Daily If not daily, indicate how often:
What other conditions affect the running of your vehicle? (e.g. different gas, rainy weather)

Have symptoms developed	Gradually Suddenly
Has your vehicle been worked on recently by us or another shop/individual? If so, what has been done ? How long ago?