Driveability Sheet

Click the "Back" button on your browser to return to the Appointment form

Symptoms	When/ Where	Environment	About How Often
Engine Lamp on	Starting	Cold, Below 33-F	Continuous
Engine Stalls	Idling	Cool, 33-70 F	Few Seconds
Hesitation / Sag	Accelerating	Warm, 71-70 F	Few Minutes
Surge/ Chuggle	Shifting	Engine Cold	Few Hours
loses Power	Cruising	Engine Warm	Few Days
Poor Fuel Economy	Slowing	Engine Hot	Few Weeks
Engine Misfire	Braking	Raining	Few Months
Backfire	Turning	Splash	Only During Event
Spark Knock	Parking	Humid	Variable, No Pattern
Engine Noise	Over Bump	Dry	Intermittent
High Idle	Uphill	Snow / Ice	Every 1 Mile
Rough Idle	Downhill	Dew / Damp	Every 2 Miles
Jumps / Jerks	Continuous	Any Environment	Every 5 Miles
Hard Starting	Any Time		Every 10 Miles
Crank but no Start	City		Every 20 Miles
No Crank	Highway		Every 50 Miles
Exhaust Odor	Anywhere		Every 100 Miles
Exhaust Smoke	Near Power Lines		Unable to Duplicate
Dieseling / Runon	Since New
Emission Test Failure	Since Work Done
Fuel Odor	After Gas Fill Up
Other	Low Fuel Level
	Hot restart
	Key on Engine Off
	Placing In Gear
	Forward
	Reverse

INTERMITTENT PROBLEMS GENERAL INFORMATION

Intermittent problems can be a very frustrating experience for both the

customer and the technician. In order to serve you better, please fill

out the information below, and check off the appropriate boxes. If

necessary, keep this form with you for a few days so the information needed will be

fresh in your mind the next time the problem occurs.

1. CUSTOMER NAME________________________________________________________

2. VEHICLE (year, make, model)__________________________________________

3. VEHICLE SYSMPTOMS/DESCRIPTION ________________________________

_____________________________________________________________________

4. WHEN DID THE PROBLEM FIRST START HAPPENING?__________________________

_____________________________________________________________________

5. HAS VEHICLE BEEN WORKED ON FOR THIS PROBLEM BEFORE? ____Yes _____No

If yes, what work was done? Did it make any difference?______________

_____________________________________________________________________

6. DOES THE CAR HAVE PROBLEM WHEN THE ENGINE IS:

________cold only _________warm only

________warm or cold _________other:(describe)____________________

_____________________________________________________________________

7. DOES THE CAR HAVE PROBLEM WHEN WEATHER CONDITIONS ARE:

_______cold only _________hot only

_______hot or cold _________wet only

_______dry only _________no difference

8. HAVE YOU NOTICED ANY UNUSUAL SOUNDS?________, ODORS?_______,

DRIPS?_________, LEAKS?_________,SMOKE?________, WARNING LIGHTS?_____

GAUGE READINGS?_________

Explain_______________________________________________________________

_____________________________________________________________________

9. ANY CHANGES IN ACCELERATION?_________, ENGINE PERFORMANCE?________,

GAS MILEAGE?__________, FLUID LEVELS?___________

Explain_______________________________________________________________

_____________________________________________________________________

10. ANY PROBLEMS IN HANDLING?___________, BRAKING?_____________

STEERING?____________, VIBRATIONS?___________

Explain_______________________________________________________________

_____________________________________________________________________

11. HOW OFTEN DOES THIS PROBLEM OCCUR:

________Every time vehicle is driven ______Once a day

_______Once a week ________Randomly ________other (explain)________________

_____________________________________________________________________

12. WHAT IS THE LONGEST PERIOD OF TIME, IN NORMAL USE, DURING WHICH YOU

DID NOT NOTICE THE PROBLEM:

________1 hour ________ 1 day

________1 week ________ other (explain)___________________________________

_____________________________________________________________________

13. OTHER HELPFUL INFORMATION: (check ALL that are appropriate)

_____ has vehicle been sitting for a long time?(if so, how long?) __________

_____ is vehicle normally garaged?

_____ is vehicle only driven short trips?

_____ has vehicle ever been in an accident? what parts were damaged?_____________

___________________________________________________________________

_____ has vehicle been stolen/recovered recently?

_____ has vehicle just been washed?

_____ have you ever noticed wet carpeting?

_____ has vehicle ever been in a flood?

_____ does vehicle have a salvage title?

_____ has the vehicle just had body work or other repairs?

_____ has a stereo or other accessory been recently installed?

_____ does the vehicle's radio have static?

_____ are there any electrical accessories that do not work?

(please list)___________________________________________________________

___________________________________________________________________

_____ have you noticed any electrical abnormalities? (explain)

___________________________________________________________________

_____ did the problem happen shortly after gas purchase?

_____ any recent changing of gas brand?

_____ any unusual raw gas smells?

_____ problem occur right after loaning car to someone else?

_____ has anyone else experienced the problem in your vehicle?

_____ does altitude seem to have any effect?

_____ does the temperature gauge ever show overheat?

_____ does the temperature gauge show very low temperature, even after driving for 20-30 minutes?

_____ does the heater take a long time to put out hot air?

_____ is vehicle equipped with any anti-theft device/alarm? does it work? yes _______no _______

_____does the vehicle have a hidden "kill" switch?

Any other information that you feel might be useful?_______________________________________

______________________________________________________________________________

Click the "Back" button on your browser to return to the Appointment form