Make an Appointment to Have Your Vehicle Serviced - Will return your email within 24 hours.
Name:
Lic Number:
State:
Zip:
Address:
City:
Mileage:
Make & Model:
Hm Ph:
Bus Ph:
Cell:
Email:
What time will you call for your vehicle?:
Year of Vehicle:
Enter numbers only: (Example: 1999)
Check the following items you will need to have checked or completed.
Lubrication
Change Oil/Filter (
See Special Coupon
)
Adjust Brakes
Change Transmission Fluid
Front End Alignment
Check AC/Heating System
Balance Wheels:
Front
Rear
Check Exhaust System
Re-pack Front Wheel Bearings
Check Steering and Shocks
Flush Radiator/Add Coolant
Aim Headlights
Engine Tune-up (Complete)
Mile Service
Description of other Service(s) Desired / Description of Problem
Terms CASH unless other arrangements have been made.
I hereby authorize the repair work hereinafter set forth to be done along with the necessary material and agree that you are not responsible for loss or damage to vehicle(s) or articles left in said vehicle(s). In case of fire, theft, or any other cause beyond your reasonable control or for any delays caused by unavailability of parts or delays in part shipments by the supplier or transporter. I hereby grant you and/or your employees permission to operate the vehicle(s) herein described on streets, highways or elsewhere for the sole purpose of testing and/or inspection. An express mechanic's lien is hereby acknowledged on above said vehicle(s) to secure amount of repairs thereto.
Enter your initials that you agree:
(First, Middle and Last Initials only - ALL CAPS)
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