Cillis Car Care BBB Accredited Business
A BBB Accredited business
 since 1982

What Is Your Car Doing?

This diagnostic form will help in describing your cars symptoms.  Once filled out, you can either submit it to us where we can either provide an educated cause and estimate based on the problems listed below or we can hold on to the form until you bring your car in.  This is not a definitive diagnosis, to accurately determine the cause of any problems you may have it is best to bring in your car where we can perform a thorough diagnosis.

We hope you will find this form helpful and time saving when dropping off your car.

Diagnostic Form

Note:  Field names with asterisks are required to accurately track your information.  Hold down the CTRL key to select multiple answers.

* First Name:        * Last Name:
* Phone:        * Email: 
* Contact Preference:  
 * What would you like us to do?  
  Car Make & Model  
Car Manufacturer:  
Car Model:  
  Symptoms  
Major Symptoms:          Leaking Fluid:
Additional comments:  
When does it happen?  
Where does it happen?  
Does it happen mostly when?  
Does engine temperature affect the problem?  
How often does it happen?