Customer Diagnostic Survey Form
ENGINE DRIVEABILITY
Client Name: ____________________________ Date: ____________________
Car Make/Model:____________________________ Licence #: ________________
THE PROBLEM OCCURS STARTING
Does the engine crank __yes __no
__ Light to medium acceleration
__ Hard deceleration Does the engine start? __ yes __no
__ Deceleration (foot off decelerator) If yes, how long does
__ Cruising (constant highway speed) it take to start? _____seconds
__ Braking slowly ____ suddenly ______
__ Turning
__ Air conditioning on Does the engine start immediately
__ Air conditioning off after starting? __ yes __ no
__ Hot days
__ Other _________________________ Does the vehicle have a remote
Ambient temperature _______ degrees starter system? __ yes __ no
Engine temperature IDLE
__ Cold __ Hot Engine idles rough/unsteady __y __n
Outside Temperature Engine idles too fast? __yes __no
__ Cold __ Hot __ Warm
THE PROBLEM STARTED PERFORMANCE
__ Gradually at ______ (odometer) __ Stalls on deceleration or quick stops
__ After abnormal occurrences (ie potholes) __ Lacks power
Before the condition occurs? ___Mins ___Hrs. __ Pings or knocks
Since the vehicle was new ______ __ Runs on after key is off
TYPE OF FUEL USED __ Backfires (popping noise)
__ Speed changes w/o accelerating
__Regular __Check engine light is on
__Mid-Grade __ Other – describe
__ Premium ________________________
__ Alternative Fuel ________________________
__ Brand of fuel ________________________
THE PROBLEM OCCURS WHEN…
__Rarely __ Sometimes __ Always