Customer Diagnostic Survey Form
HEATING AND COOLING SYSTEM
Client Name: ____________________________ Date: ____________________
Car Make/Model:____________________________ Licence #: ________________
UNUSUAL NOISES AIR CONDITIONING
Are there any unusual noises? __Yes __ No Is there any cooling effect? __Yes __ No
If yes, please describe the noises and If No, how long has the A/C been
Where it seems to be coming from: inoperable? _________ months
_____________________________
_____________________________ If yes, how long does it take
_____________________________ to cool the vehicle? _________mins/km
_____________________________ How many days since the air
_____________________________ conditioner was operated? ______ days
Noise increases with engine speed? Noise occurs when A/C
__Yes __ No compressor is on? __ Yes __ No
Noise changes when control lever is moved Outlet temperature fluctuates back
To change outlet? __ Yes __ No and forth? __ Yes __ No
Cooling effectiveness fades?__Yes __ No
UNUSUAL ODOURS
Are there any unusual odours? __ Yes __ No
If yes, please describe (ex. Oily, chemical, etc) HEATING
_______________________________ Does the heating system work
_______________________________ properly? __ Yes __ No
Is there any heating effects?__Yes __No
THE PROBLEM STARTED If yes, how long does it take to warm
The vehicle? ________ mins/km
__Suddenly at ________ (odometer)
__Gradually at ________ (odometer) Ambient temperature outside?
__ Just started ________ (odometer) __________Degrees
__Since the vehicle was new
THE PROBLEM OCCURS AIRFLOW
__Rarely Can airflow be changed to different
__ Sometimes outlet? __ Yes __ No
__ Always If no, which outlets don’t work?
__Center __ Left __ Right
__ Floor __ Defroster
Does recirculation mode work?
__ Yes __ No
If no, which does not work?
___ Fresh
___ Recirculation