Drivability Worksheet

To provide a quick, complete and accurate diagnosis of your vehicle our technicians need a thorough description of the problem. Please take a few minutes to complete this worksheet to the best of your ability. The information you provide will be a tremendous aid to the technician.

Vehicle Information

Date:

Name:

Phone:

Year:

Make:

Model:

Engine:

Mileage:

VIN:

 

Drivability Symptoms

Please check all symptoms that apply to your vehicle

My vehicle's "CHECK ENGINE" light

Glows steadily

  Glows intermittently

  Never comes on

While operating the starter, my vehicle

Will not crank

Cranks slowly

Cranks normally

When starting, my vehicle

Will not start

Starts normally

Starts and dies

Is difficult to start:

  Hot

  Cold

While Idling, my vehicle

Will not idle

Idles too low

Idles too high

Idles rough

Surges (up and down)

Backfires

Idles normally

While driving, my vehicle

Backfires

Pings (Spark knock, detonation)

Smokes excessively

Runs too hot

Runs too cold

Black

Blue

White

Has a fuel or gas odor

Hesitates

Stumbles

Stalls

Surges

Lacks power (sluggish)

Misses

Cuts out

Stalls when slowing or stopping

Vibrates excessively

Other symptoms

Transmission shifts

Too soon

Too late

Normally

Poor fuel mileage

Emissions test failure or "rotten egg" odor

Other (Please explain)

Conditions of Occurrence

Time:

Speed:

Distance:

Morning

Idle

Less than 2 miles

Midday

Low speed

From 2 to 10 miles

Evening

Stop and Go

More than 10 miles

Night

Highway (Cruise)

 

High speed

Conditions:

 

Acceleration

Uphill

 

Deceleration

Downhill

Frequency of Conditions

Always

Since New

Intermittently

After_______ miles

Environmental conditions

Cold Weather

Wet/Raining

Fog

Hot Weather

Snow

Dirt/Dust

Engine Conditions

Engine Cold

While Turning

Engine Hot

While Braking

All Temperatures

With Headlights ON

When Shifting

With A/C ON

Driving Habits

Start cold engine and drive immediately

Star cold engine and allow to warm up

Mostly highway driving

Mostly city driving

Park in garage
Average miles driven per day_____________

Fuel Quality

Type of fuel used______________________

Octane rating

  87

89

91

Greater than 91

Brand of fuel_______________________________

Last fill-up date_____________Miles____________

 

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Revised: 08/24/05.