Quick Links
OC Home
OC Home > Work Request Form
Work Request Form
    Customer Information:
    Today's Date: 3/19/2010     Customer Name:

    Best Way to Contact you:
    Phone Number:   Email Address:

    Vehicle Information:
    Year: Make: Model:

    Service Request Information:
    Request for service - Please indicate current mileage or service needed:
    Mileage: Service:
    Request for diagnosis and/or repair - Please describe your symptoms and concerns in the space below. What is happening (noise, stumble, etc.)? When is it happening (cold weather, on start-up, up hills, etc.)? This information is important for us now to be able to diagnose your concern accurately, as well as later to be able to verify that we have fully repaired it.

    Please describe any time and/or schedule constraints or special requests below:

    Jobs are selected based upon training value and NOT in the order received. Not all jobs are selected. Vehicles must have current license and insurance. Any charges will be approved before work is completed.