Customer Diagnostic Survey Form

REAR WHEEL DRIVE TRANSMISSION

Client Name: ____________________________             Date: ____________________

 

Car Make/Model:____________________________       Licence #: ________________

 

 

DEFINE THE PROBLEM…                       ROAD TEST…

 

DESCRIPTION                                         Is a road test really necessary? __Yes __No

                                                                If yes, please explain why| ______________

____________________________                      ___________________________________

 

____________________________                ___________________________________

 

____________________________                  ____________________________________

 

____________________________                  ____________________________________

 

____________________________                  ___________________________________

 

Condition present when hot?  ___ Yes  __ No

Condition present when cold? ___ Yes __ No

Is the condition evident now?  ___ Yes __ No

Is the condition intermittent?   ___ Yes __ No

Has the transmission been

Previously repaired?                 ___ Yes __ No

Does the vehicle pull a trailer? ___ Yes __ No                           

    

Back to Services Page