Name: *

First

Last

Vehicle Year, Make, Model: *

License # and State: *

Approx. Mileage:

Do Any Of These Pertain To You Recently? *

Entertainment System Replacement
Alarm System Install
Past Heating Or Air Conditioning Repairs
Vehicle Modifications / Conversions
Major Mechanical Repairs
No, None Of These Apply To Me

Select All That Apply

Does The Heater Turn On? *

Yes
No
Not Sure

Describe Your Condition: *

It's Hot, Then Cold
Not Enough Air Flow
It's Just Not Warm Enough
It's Always Cold

Select All That Apply

Does The Heater Keep You Warm Enough? *

Yes
No

Do You Have Dual Zone Heat? *

Yes
No
Not Sure

Do All Vents Blow Warm Air? *

Yes
No
Not Sure

Which Ones Don't? *

Do All Vents Work Properly (open and close)? *

Yes
No
Not Sure

Which One(s) Don't Work?

Defrost
Side Vents
Center Vent
Floor Vents

Select All That Apply

Does The Rear System Turn On? *

No Rear System
Yes
No
Not Sure

Do You Hear The Fan Work? *

Yes
No
Not Sure

Does The Fan Make Noise? *

Yes
No

Describe Is The Noise(s)? *

Are There Dash Noises When Changing The Controls? *

Yes
No
Not Sure

Describe The Noise(s) *

Does Your Car Overheat? *

Yes
No
Not Sure

Do You Smell A Sweet Odor Inside The Vehicle? *

Yes
No
Not Sure

When You Turn On The Defrost Do The Windows Fog Up? *

Yes
No

What Is The Outside Temperature When The Problem Occurs? *

Cold (32/50F)
Very Cold (Below 0/31F)
Always

What Speed Are You Driving? *

0-25 MPH
26-50 MPH
51-65 MPH

Select All That Apply

How Long Are You Driving? *

5 Minutes
10 Minutes
20 Minutes
All The Time

If Another Shop Worked On This Problem, What Did They Find?

What Was The Last Service Performed On The Vehicle?

Additional Information:

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Diagnostic Form – Heater

Please take a moment to fill out this form. We created it to help you help
us to better determine your vehicles concern. Please fill it out to the best
of your ability to save us time and you $$$!

Join Our Customer Care & Rewards Program!

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Hours

Diagnostic Form – Heater

Please take a moment to fill out this form. We created it to help you help us to better determine your vehicles concern. Please fill it out to the best of your ability to save us time and you $$$!

Join Our Customer Care & Rewards Program!

Call Us

Visit Us

Hours

Please take a moment to fill out this form. We created it to help you help
us to better determine your vehicles concern. Please fill it out to the best
of your ability to save us time and you $$$!