Leisure World Auto Repair - Appointment/Estimate

To Make A Service Appointment or obtain a work estimate, fill out form and submit. Supply all information requested. THIS WILL SPEED UP YOUR ESTIMATE OR INTAKE AND WORK. A representative will phone you upon receipt of this form to confirm the date and time of your service appointment and/or supply an estimate.

Name: First Last
Address
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Your Email Address:
Automobile - YEAR, MAKE, MODEL
License Plate Number
Mileage (Odometer Reading)
Vehicle Identification Nmber (VIN)
Indicate Date You wil Bring In Car For Service: / MM / DD YYYY
Indicate Time Of Day You Will Bring In Car For Service: : HH MM AM/PM
Check off one or more of the below items: I wish to WAIT for my car repair to be completed. I will leave my car at your shop until the repair is completed and then pick it up. I will deliver my car to your shop for repair work, but need a ride back to my home or office.
PLEASE PERFORM THE BELOW MAINTENANCE: Lube, Oil Change & Filter Check all fluid levels and top off. Rotate Tires Check all belts and replace any required. Check brakes and repair as required after calling me with an estimate. Drain transmission fluid and fill. Replace filter. Check cooling system and report. SMOG TEST VEHICLE Check battery and perform any required maintenance. Replace air filter, breather element and PCV valve (if equipped) Check cooling system and replace required fluids. Check fuel filter and replace if required. Vehicle Inspection (current car or pre-purchase of car)
I REQUIRE THE BELOW MAJOR REPAIR WORK (i.e. engine, transmission) Describe in detail.