Diagnostic Questionnaire - New Duston Garage

Contact Details

1/10

Customer Name:

Contact Number:

Email Address:

When your car is with us, how would like us to get in touch?

Phone

Text

Vehicle Information

2/10

Vehicle Make:

Vehicle Model:

Year of Manufacture:

Registration Number:

Mileage:

Symptoms & Issues

3/10

Type of Issue:

Describe the Problem:

When Did the Issue First Occur?:

How often does the issue happen?

Always

Often

Sometimes

Once

Driving Conditions

4/10

When does the issue mostly occur?

At startup

While idling

When accelerating

While braking

At high speeds

At low speeds

In reverse

What are the weather conditions when this issue occurs?

All conditions

Dry

Wet

Cold

Hot

Warning Indicators

5/10

Dashboard Warning Lights:

Check Engine

ABS

Airbag

Oil Pressure

Other Warning Light

Sounds & Sensations

6/10

Sounds Associated with the Issue:

Clicking

Whining

Grinding

Squealing

Rattling

Rumbling

Other (describe)

Where is the sound coming from?

Front

Rear

Left

Right

Centre

Underneath

Not Sure

Other (describe)

Sensations During the Issue:

Shaking

Pulling to one side

Loss of power

Overheating

Other (describe)

Related Functions

7/10

Affected Vehicle Functions:

Steering

Braking

Acceleration

Gear Change

Heating/Cooling

Lights

Wipers

Other (describe)

Is this affecting drivability?

Severely

Moderately

Not at all

Prior Steps Taken

8/10

Temporary Fixes Attempted:

Have you consulted another garage for this issue?

Yes

If yes, please provide details:

Previous Repairs & Maintenance

9/10

Last Service Date:

Services Performed:

Previous Repairs related to the issue:

Has this vehicle been a total loss?

Yes

Additional Comments

10/10

Any other concerns or special instructions

Contact Details

Vehicle Information

Symptoms & Issues

Driving Conditions

Warning Indicators

Sounds & Sensations

Related Functions

Prior Steps Taken

Previous Repairs & Maintenance

Additional Comments

Thank you!

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