Help us Help You

Please complete a contact information form and a symptom questionnaire.  Simply copy and paste this contact form and the appropriate symptom questionnaire (ie: brake inspection, inspect for leak, overheating, etc.) into a word document or email.  You may bring in this information when you drop your vehicle off or you may email us at FrontDesk@IntegrityAutomotive.net.  Still have questions? Give us a call at 573.0107.

Contact Information

NAME_______________________________________________

ADDRESS___________________________________________

CITY______________________STATE______ZIP CODE______

PRIMARY CONTACT # ________________________________

SECONDARY CONTACT # _____________________________

YEAR___________  MAKE___________  MODEL___________

Do you need your vehicle back to you by a certain time?____

Do you have any coupons or discounts?

Maintenance Service

Oil Change  o                       oil preference?

$49.95 Oil Change/Rotate Special  o

Scheduled Maintenance  o              Current Mileage?_________

Are you a member of the Oil Change Club? Y_________N_________

Would you like more information on how you can become an Oil Change Club Member? Y_________N_________

Inspect for Leak

How do you know you have a leak?

Quantity/Color

Have you been adding fluid?

How often? or How many times?

How much? Pt/Qt/Gal.

How long has this been leaking?

Is there a warning light or gauge readings that are unusual?  How long?

Inspect for Noise

Type of Noise

Frequency

Wheel speed related? (while car is moving)

Engine speed related? (while car is sitting still)

How long has it been making noise?

Proximity - front, back, right, left, inside passenger compartment, outside, under hood?

How can we duplicate the symptom?

Window Inspection

SYMPTOMS:

Which window?

If more than 1 window isn’t working, did they fail at the same time?

Is it stuck up or down?

Does it go too slow?

Does it make any noise?

When did the symptom(s) start?

Overheating Inspection

What led you to believe you vehicle was/is running hot?

Did the temperature light come on or did the gauge go into the red?  ___YES ___NO

How long was the car driven in an overheated state?

Miles or minutes?

Has the vehicle been recently serviced or repaired?

___YES   ___NO

If Yes, what was done?

Have there been any other significant events such as being involved in a collision or was there an impact with a road hazard?

Heater Inspection

Do you have any heat blowing out?

Does the fan work? On all speeds?

Is there a smell?

Is there smoke?

Does the gauge work?

Do you have to add coolant? How much?

When was the last time it worked well?

AC Inspection

No cool -  Low cool - OTHER

When are you having problems with the A/C?

___Morning?       ___When it’s hot?

Does the blower fan work on all speeds?

If no, what speeds work?

When was the last time that you’re A/C worked well?

Has it been previously charged or repaired?

If so, whom? When?  Was dye added?

Fuel Economy Inspection

Have there been any changes in your driving habits?

What type of driving?

___In-Town                ___Highway

What is your normal trip range?

___miles per day  ___short distances ___long distances

What type of gas is used?                  Brand?

What is your estimated mpg?  What is your expected mpg?  Have you ever achieved that?

What is the method that you use to measure your mpg?

Last tune-up?

Brake Inspection

Any recent service or repairs to brakes or otherwise?

Any warning lights on the dash?

SYMPTOMS:

Noise associated with brakes or braking?

- How long has the noise been going on?

- Noise when braking or noise goes away when braking?

- Type of noise: squeal, squeak, grind, other ?

- front - rear - right - left

- When?

- 1st am - goes away after a few stops

- at the end of a stop

- after driving for a while and brakes are hot?

Define type of driving and how far in miles.

- in town - slower speeds?       highway - faster speeds?

Vibration - shimmy?

From what speed is it most noticeable? Braking from highway speed or in town driving?

Where do you feel the vibration? steering wheel, brake pedal, other?

Low pedal or pedal goes to floor

How long has the symptom been going on?

- Does it occur every time you try to brake? If not how often?

- Have you added brake fluid recently?

Pulls right or left when braking

- How long has the symptom been going on?

- From highway speed or in town driving?

- Does it occur every time you try to brake? If not how often?

Drivability

Please describe the vehicles problem as accurately as you can:

Is the Check Engine light on?

If yes, how long has it been on?                          Is it flashing?

Was it flashing first thing or was the light on solid initially?

Any recent repairs?

Any recent upgrades? (stereo, amps, gps, battery, filters?)

Check the item(s) that best describe the symptom(s)

___No Symptoms-starts & runs ok

___Starts, but stalls

___Hard Start

___Won’t stay running

___Cranks, No Start

___No Crank (no noise), No Start

___Rough Idle

___Fast Idle

___Slow Idle

___Misses/Cuts Out

___Hesitation

___Lacks Power

___Vibration

___Surge/Chuggle

___Overheating

___Noisy

___Poor Fuel economy___mpg

___Pinging

___Odor

___Smoke

___Warning light (s) other

than C.E. light

Check the item(s) that best describe WHEN the symptom(s) occur:

___Only happened 1x        When?

___All of the time                    ___At Idle

___Hot                                     ___On Deceleration

___Cold                                   ___On Acceleration

___Wet/Rainy                          ___Constant Speed ___mpg

___Recurring

___Every time it’s driven

___1x a day-week-month-other?