Vehicle Performance Checklist

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Thank you for taking the time to complete our vehicle performance checklist.

    Contact Information

    Name*

    Address*

    City / State / ZIP*
    ,
    Cell Phone*

    Preferred Method of Contact:

    Email*

    Address 2

    Home Phone*

    Work Phone

    Are you the Registered Owner?

    Vehicle Information

    Owner's Name*

    Mileage

    Make / Model*

    Has this vehicle been here before?

    Plate / Tag Number

    Year*

    Color

    Do you drive this vehicle daily?

    Engine Performance Checklist

    When was the last time you had Engine Performance work done on your car?

    Select a Problem Below to Complete Form:

    Battery/Starting Problems

    1. Crank over slowly? When engine is coldWhen engine is hotAlways
    2. Make unusual noises while cranking?
    3. Crank/Spins over OK, but does not start: When engine is coldWhen engine is hotAlways

    Running Problems

    1. Stall at idle: When engine is coldWhen engine is hotWith A/C onUnder light accelerationAlways
    2. Run rough: When engine is coldWhen engine is hotWith A/C onUnder light accelerationAlways
    3. Misfire or hesitate: When engine is coldWhen engine is hotWith A/C onUnder light accelerationAlways
    4. Have any dash lights been on? If yes, which ones:

    Air Conditioning Symptoms Checklist

    1. Does A/C system cool?
    2. Does the fan / blower work? All Speeds?
    3. Is the fan / blower noisy?
    4. Do all dash controls work ok?

    Air Conditioning Symptoms Checklist

    If Above questions are "NO" please continue with questions 5-10

    5. Is A/C noisy when turned on?
    6. Does car stall or idle funny when A/C is on?
    7. Does your car overheat?
    8. If you have an A/C filter, has it ever been replaced?
    9. When was the A/C system serviced last?
    10. Does A/C or heater smell?

    11. Other A/C Problems

    Steering or Suspension Problems

    Symptoms Checklist

    1. Does vehicle drift, lead or pull? If Yes: LeftRightWhen BrakingAll the Time
    2. Does vehicle wander? If Yes:
    3. Do you feel any vibration? If Yes, what speed:
    4. Are front tires worn irregular?
    5. Are rear tires worn irregular?
    6. Is steering wheel straight when you're driving straight ahead?
    7. Does steering seem loose?
    8. Any unusual noises when going over bumps?

    9. Other Steering/Suspension Problems

    Brake Symptoms Checklist

    1. Does your car stop OK?
    2. The brake pedal seems:
    3. Does the vehicle:
    4. Do the brakes:
    5. The Emergency/Park Brake:

    If it doesn't work properly, explain:

    6. Has brake fluid been added in the last 6 months?
    7. Have the brakes been Adjusted in the last 6 months?
    8. Last time brakes were serviced and repaired?

    9. Other Brake Problems

    Other Problems

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