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Diagnostic Problem or Driveability Problem
Date to drop off vehicle:
Your Name:
Your Phone Number:
Your Email Address:
Mileage:
Make:
Year:
Model:
Engine:
Description of Problem:
When did the problem first occur?
List previous repairs in the last 6 months:
Does vehicle have aftermarket stereo equipment?
Subwoofer Speakers
Capacitor(s)
Auxiliary Battery(s)
High Output Alternator(s)
Amplifier(s)
Starting problems?
Will not crank
Cranks, but will not start
Starts, but takes a long time
Engine quits or stalls?
Right after starting
When put into gear
During steady speed driving
Right after vehicle comes to a stop
While idling
During acceleration
When parking
All the above
Poor idling conditions?
Is to slow at all times
Is too fast
Intermittently too fast or to slow
Is rough or uneven
Fluctuates up and down
Poor running conditions?
Runs rough
Lacks power
Bucks and jerks
Poor Fuel Economy
Hesitates or stumbles on acceleration
Backfires
Misfires or cuts out
Engine knocks, pings, rattles
Surges
Dieseling or run-on
Auto. Transmission problems?
Improper shifting (early/late)
Changes gear incorrectly
Vehicle does not move when in gear
Jerks or bucks
Usually occurs?
Morning
Afternoon
Anytime
Engine Temperature
Cold
Warm
Hot
Driving conditions
During occurrence
Short-less than 2 miles
2-10 miles
Long-more than 10 miles
Stop and go
While turning
While braking
At gear engagement
With A/C operating
While headlights on
During acceleration
During deceleration
Mostly curvy
Rough road
Driving habits
Mostly city driving
Highway
Park vehicle inside
Park vehicle outside
per Day: -10 miles
per Day: 10-50 miles
per Day: +50 miles
Gasoline used: Fuel Octane:
87
89
91
More than 91
Single Line Text
Temperature when problem occurs
32-55ºF
Below freezing (32ºF)
Above 55ºF
Check engine light/
Dash warning light
sometimes
always
Light never on
Smells
Hot
Gasoline
Oil Burning
Electrical
Noises
Rattle
Knock
Squeak
Other