Drivability Level 1 Worksheet

To provide a quick, complete and accurate diagnosis of your vehicle our technicians need a thorough description of the problem. Please take a few minutes to complete this worksheet to the best of your ability. The information you provide will be a tremendous aid to the technician.

SYMPTOMS- in your own words: (Please Print)


Are there any other problems or conditions with the car, related or unrelated? (don't roll the window down, jiggle the key to start etc ... )


When was the last time someone worked on your car?


What did they do? (Can you provide an invoice showing what was perfonned?)


Did the condition exist before their repair?
Yes	No

COMMENTS:


My vehicle's "CHECK ENGINE" light
Never comes on	Glows steadily	Flashes
Comes on intermittently

Are there any other warnings or indicator lights coming on:
None	ABS (Anti-Lock Break System)	Coolant
Brake	SRS (Air Bag)
Temperature	Oil Pressure	Low Air Pressure
Traction Control	Battery

While Starting My Car It:
Starts Normally	Will Not Crank	Cranks Slowly
Starts And Dies	Makes A Noise	Other
Explain:


While Idling, My Vehicle:
Idles Normally	Will Not Idle	Idles Rough
Idles Too Low	Idles Too High	Surges (Up & Down)
Backfires	Other
Explain:


While Driving My Vehicle:
Drives Normal	Backfires	Pings (rattle noise under acceleration)
Smokes(please indicate color of smoke) Black Blue White
Explain where you see it (hood, tailpipe etc..)


Smells
Rotten Egg	Coolant	Gasoline
Burning	Plastic	Other
Explain:


Other Symptoms:
Transmission shifting
Normal	Hard Shift	Delayed (slipping)
Doesn't Shift	Poor Fuel Mileage	Other
Explain:


Conditions of Occurrence:
TIME:
Always	Morning	Midday
Evening	Night

SPEED:
Any Speed	Idle	Low Speed
Stop & Go	Highway(Cruise)	High Speed
Acceleration	Deceleration

DISTANCE:
Any Distance	Less Than 2 Miles	2 To 10 Miles
More Than 10

ENVIRONMENTAL CONDITION:
Any Condition	Cold Weather	Hot Weather
Wet	Other
Explain:


Uphill	Downhill	Level Ground
Other
Explain:


ENGINE CONDITION:
All Conditions	Engine Cold	During Warm Up
Operating temperature	Other
Explain:


Does your engine overheat?
Yes	No

When does this happen?


FUEL QUALITY USED:
Type Of Fuel Used
Octane Rating
Last Fill Up Date
Current Miles

The process for diagnostics and repair can become time consuming. Part of that process is being able to reach the customer in a timely manner. Some diagnostic processes can be as high as $364 with the average repair cost being around $600. If you are comfortable with preauthorizing a dollar amount in an effort to speed the repair process forward please fill in an amount below:

I authorize Parkway Automotive services to both diagnose and repair my vehicle not to exceed $ without contacting me further. If the repair cost after diagnostics will exceed the amount preauthorized I request that contact be made before any part is installed.
Signed:	Service advisor
I accept