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Car Make/Model & Year

Licence #

When can you drop your vehicle off?

Define The Problem(s)

 Vibration Noise & Water Leaks Heating & Cooling System Engine Drivability Automatic Transmission Braking System Front Wheel Drive Analysis Rear Wheel Drive Analysis Other

It Happens When

The problem occurs

 Light to medium acceleration Hard acceleration Deceleration (coast in gear) Declaration (coast out of gear) Cruising (constant highway speed) Braking Turning None/Other

Speed of vehicle

Describe the speed at which the problem occurs: km/h

Road Conditions

Describe the road conditions on which the problem occurs:
 Paved Road (smooth) Paved Road (rough) Wet Road Going Over Bumps Other

The Problem Started

 Suddenly Gradually Just Started Since the vehicle was new After abnormal occurrence (ie: pot holes, curb impact etc)

The Problem Occurs

 Rarely Sometimes Always
Have the tires been balanced?  yes  no
Were any repairs performed prior to the condition occurring?  yes  no

Comments, or Concerns