Customer Concern Worksheet

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Customer Concern Worksheet

Thank you for choosing our shop!

To better serve you and ensure your vehicle gets the care it needs, please take a moment to answer the following questions:

Contact Us

First Name:

Last Name:

Describe the problem your car is having.

Attach Audio/Video file if applicable. (must be less than 10 mb)

Upload File

Has your vehicle been serviced recently at a facility other than ours? (even if it is unrelated to your concern it may help us isolate the problem)

Yes

If you answered yes to the question above please describe your service history. You can also type yes and send us a copy of your records. If no type no in the text box.

What temperature does it happen

All

Very cold 32 and below

Cold 32-45

Moderate 45-60

Warm 60-75

Hot 75-80

Very hot 85+

When does it occur? (Check all that apply)

All the time

Intermittent there doesn't seem to be any rhyme or reason to it

Only when its wet, raining, or snowing

Pot holes

Engine not running

Parking lot maneuvers

At road speed

When accelerating

On deceleration

Braking

Only with the air conditioning on

Pot holes

Speed bumps

Small bumps

Smooth pavement

Turning left

Turning right

Idle in gear

Idle in park

Only first thing in the morning or after the car has been sitting for a while

After I have been driving for a while and the engine is hot

How long has it been happening?

Days

Weeks

Months

Intermittently for weeks

Intermittently for months

Just started

Any other information that you think is relivant

Thank you for contacting us.
We will get back to you as soon as possible.

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High Line Auto Service

336 Chapel Rd. South Windsor, CT 06074

(860) 254-5350

South Windsor, CT 06074

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