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.