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AUTO REPAIRS
SCHEDULE A REPAIR
DIAGNOSTICS & MAINTENANCE
STEERING & SUSPENSION SERVICES
TIRE CARE TIPS
BRAKE REPAIRS
DRIVECARE INSTALLATION
WHEEL ALIGNMENTS
DOMESTIC & FOREIGN CAR REPAIR
DOMESTIC VEHICLE SERVICE
ASIAN CAR SERVICE
EUROPEAN CAR SERVICE
LEVELING KITS
CAR CARE TIPS
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FIRESTONE TIRES
BRIDGESTONE TIRES
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Vibration Form
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Vibration Form
VIBRATION
CUSTOMER DIAGNOSTIC SURVEY FORM
Customer Name:
License #:
Date:
It Happens When...
The Problem Occurs
The Problem Occurs:
Light to medium acceleration
Hard acceleration
Deceleration (coast in gear)
Deceleration (coast out of gear)
Cruising (constant highway speed)
Braking
Turning
Speed Of Vehicle
Describe the speed at which the problem occurs: Vehicle speed (km / h)
Engine Speed
Idle
Medium
High
Road Conditions
Describe the road conditions on which the problem occurs:
Paved road (rough)
Wet road
Paved road (smooth)
Going over bumps
List other road conditions
The Problem Started
The Problem Started
Suddenly at (odometer*)
Gradually at (odometer*)
Just started (odometer*)
Since the vehicle was new
After abnormal occurrence (i.e. pot holes, curb impact)
List odometer
The Problem Occurs
The Problem Occurs
Always
Intermittently
Occasionally
Have the tires been balanced?
Yes
No
Where any repairs performed prior to the Condition occurring?
Yes
No
Define the problem...
Vibration
Please check the box that best describesthe vibration you “feel.”
Wobble (side to side)
Shake (usually caused visual movement)
Pumping feeling (usually very slow movement)
Harshness (stiffness, loss of ride quality)
All of the above
Please check the box that best describes where you “feel” the vibration.
Steering wheel
Seat
Floor
All of the above
If none the above, please describe where the vibration seems to be coming from.
Send
