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Customer Information |
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Name: |
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House No. or Name: |
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Street/Road: |
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Town/City: |
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Post Code: |
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Contact Number: |
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Fax: |
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E-mail: |
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Please Contact Via: |
Phone
Fax
E-mail
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Vehicle
Information |
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Registration Number: |
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Chassis Number: |
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Model: |
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Vehicle Year: |
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Vehicle Mileage: |
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Booking Required for |
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Service Menu: |
Oil Service
Oil Service and Safety Service
Inspection I
Inspection II
Brake Fluid Change
Coolant Change
Front Brake Pads
Rear Brake Pads
Front and Rear Brake Pads
Air Conditioning Micro Filter Change
Air Conditioning Service
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Repair Line 1#: |
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Repair Line 2#: |
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Problem Checklist |
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Please take a
moment to complete the Problem Checklist in the event one or
more of your concerns involve repairing any drivability,
noise or leak problems. We welcome the opportunity to have
the workshop manager test drive your BMW/MINI with you so
you may point out any concerns. It is our sincerest desire
to repair your concerns right the first time, on time, every
time. Your assistance may be vital to our success. |
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History |
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Has the problem been previously diagnosed or worked on? |
Yes
No |
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yes, by Specialist Cars or some other dealer? |
Specialist
CarsSomeone
else |
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When was the work done? |
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What was done to try to correct the problem (if done by
another workshop?) |
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Can problem/symptom be duplicated on a test drive? |
Always
Sometimes |
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How often does it occur? |
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After what length of time (minutes, hours, number of miles)? |
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Road
Conditions |
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Smooth |
Bumpy |
Pothole |
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Speed bump |
Stop and Go |
Motorways |
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Uphill |
Downhill |
Turning |
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Weather
Conditions |
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Sunny, Rain, Fog, Snow, Ice, Overcast, Windy? |
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Vehicle |
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Road Speed? |
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Number of passengers including driver? |
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Load in boot? |
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Leaks |
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Have you noticed any leaks? |
Yes
No |
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yes? |
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Location of leak? |
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Colour of leaked fluid? |
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Amount (how much was added)? |
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Noises |
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Have you noticed any noises? |
Yes
No |
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If yes? |
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Reservation Date |
Please
enter preferred date or dates (please allow 5 working days) |
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Dealer |
Luton
Stevenage |
