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Brake Concern Form

“Your” Car Care Maintenance Plan

Noise / Vibration Concern

Drivability Concern

Fluid Leak Concern

Brake Concern Form

Name(Required)

First Last

Phone(Required)

Email(Required)

Vehicle Year(Required)

Vehicle Make(Required)

Vehicle Model(Required)

When are the noises?

Always

Intermittent

Rarely

Where do you think the issue is located?

Drivers Side Front

Passengers Side Front

Drivers Side Rear

Passenger Side Rear

Front

Rear

Please check all that apply.

Does your vehicle stop okay?

Yes

No

The brake pedal seems...

To work okay

Hard

Soft

Too high

Too low

Spongy

To pulse or chatter

To work better when pumped

To return too slowly

Please check all that apply.

Does the vehicle:

Stop Straight

Pull left when braking

Pull right only when braking

None of the above

Please check all that apply.

Do the brakes:

Make Noise when Brakes Applied

Noise goes away when Brakes applied

Grab (You touch the brakes and they react in a far stronger way than they would normally)

Vibrate / Pulsate

Seem to be dragging (Feels like you are applying light pressure to the brakes)

Please check all that apply.

The emergency / parking brakes

Work okay

Don't work properly

Are rarely used

Has brake fluid been added in the last 6 months?

Yes

No

Are any of these warning lights on?

ABS Yellow

Brake Lamp Red

Traction Light

Stabilitrac Light

Have any repairs been done recently? If so, please specify.

Additional Information if required

Download Print Version – Brake Form

“Your” Car Care Maintenance Plan

Caring for and maintaining your car is the most important factor in ensuring that it enjoys a long and healthy life. Some repairs to your car are inevitable as it ages due to regular wear and tear. However, by caring for and maintaining your car properly, many repairs can be minimized or even eliminated altogether saving you money. A maintained vehicle is safe and reliable vehicle for you, your family and others.

Name(Required)

First Last

Phone(Required)

Email(Required)

Vehicle Year(Required)

Vehicle Make(Required)

Vehicle Model(Required)

How long have you owned the Vehicle?

Since New

Less than a Year

1-2 Years

2-3 years

3-4 Years

4-5 Years

Over 5 years

How long do you plan on keeping the vehicle?

Less than a Year

1-2 Years

3-4 Years

4-5 Years

Over 5 years

Could your vehicle be passed onto a family member or Friend?

Yes

No

Unsure

Transmission Service (Every 80000 Kms Service)

Add this Service to my "Car Care Plan"

I've had this done

Need More Info

Differential Service (Every 80000 Kms Service)

Not Applicable (Its Front Wheel Drive)

Add this Service to my "Car Care Plan"

I've had this done

Need More Info

Transfer Case Service (Every 80000 Kms Service)

Not Applicable (It's 2WD)

Add this Service to my "Car Care Plan"

I've had this done

Need More Info

Fuel Filter (Yearly Service Interval)

Not Applicable (Has None)

Add this Service to my "Car Care Plan"

I've had this done

Need More Info

Power Steering Service (Every 80000 Kms Service)

Not Applicable (Electric Steering)

Add this Service to my "Car Care Plan"

I've had this done

Need More Info

Timing Belt (Around 100000 kms Service)

Not Applicable (No Timing Belt)

Add this Service to my "Car Care Plan"

I've had this done

Need More Info

Diesel EGR Cleaning (Yearly Service Interval)

Not Applicable ( Not a Diesel)

Add this Service to my "Car Care Plan"

I've had this done

Need More Info

Spark Plugs (Every 120000 kms Service)

Not Applicable (Diesel / EV)

Add this Service to my "Car Care Plan"

I've had this done

Need More Info

Fuel Injection and Carbon Cleaning (Yearly Service Interval)

Not Applicable (Diesel / EV)

Add this Service to my "Car Care Plan"

I've had this done

Need More Info

Cabin Air Filter (Yearly Service Interval)

Add this Service to my "Car Care Plan"

I've had this done

Need More Info

Brake Fluid Exchange (Every 50000 kms Service)

Add this Service to my "Car Care Plan"

I've had this done

Need More Info

Cooling System Service (Every 120000 kms Service)

Add this Service to my "Car Care Plan"

I've had this done

Need More Info

Engine Air Filter (Yearly Service Interval)

Add this Service to my "Car Care Plan"

I've had this done

Need More Info

Brake Service (Pads, Caliper, Sliders) (Yearly Service)

Add this Service to my "Car Care Plan"

I've had this done

Need More Info

Engine Serpentine Belt (Every 100000 kms Service)

Add this Service to my "Car Care Plan"

I've had this done

Need More Info

A/C Service (Yearly Interval)

Not Applicable (No A/C)

Add this Service to my "Car Care Plan"

I've had this done

Need More Info

Tire Rotation (Every 12000 kms)

It's done with my Seasonal Tire Change

Add this Service to my "Car Care Plan"

I've had this done

Need More Info

Wheel Alignment Check (Yearly Service)

Add this Service to my "Car Care Plan"

I've had this done

Need More Info

Comments

This field is for validation purposes and should be left unchanged.

Download Print Version – Your Car Care Plan

Noise / Vibration Concern

Name(Required)

First Last

Phone(Required)

Email(Required)

Vehicle Year(Required)

Vehicle Make(Required)

Vehicle Model(Required)

The concern occurs(Required)

Always

Sometimes

Rarely

Is this a Noise or Vibration Concern(Required)

Noise

Vibration

Both

At what speed does the Concern occur?(Required)

In km/h

When did you notice the concern?

Suddenly

Gradually

Recently

Since a service or repair was done

Suddenly? Gradually? Recently? Since New? After an abnormal instance (ex. Pot holes, curb impact, etc)?

If since a previous service or repair, please describe what was done.

When does the concern occur?

Light to medium acceleration

Hard acceleration

Deceleration

Cruising (consistent speed)

Braking

Turning

In reverse

First thing in the morning

Normal road

Driving in a parking lot

Rough road

Going over bumps

Wet road

With vehicle occupants

Cold weather

Please check all that apply.

Where is it felt / heard?

Front Of Vehicle

Rear Of Vehicle

Steering Wheel

Floor

Seat

Mirrors

Instrument Cluster (Dash)

Console

Brake Pedal

Clutch Pedal

Accelerator Pedal

Gear Shift Lever

Please select all that apply.

Which type of noise fits your concern?

Engine Noise

Brake Noise

Vibration Noise

Wind Noise

Suspension Noise

Instrument Panel Noise

Interior Noise

Does any action stop or change the noise / vibration?

Bang (Any brief, loud and sharp sounds almost like a gun firing.)

Buzz (A constant sound that can also be felt through the steering wheel or vibrations through the floor.)

Click (A light sound, like a ball-point pen being clicked.)

Clunk (An abrasive sound, like a grinding stoned.)

Grind (A harsh metal-on-metal scraping noise.)

Hiss (It sounds like air or steam escaping from somewhere.)

Rattle (The same sound as marbles rolling around in an empty can.)

Thump (A loud dull noise)

Tinging (A high pitch tone)

Squeak (A short shrill cry or noise)

Whine (A drawn out higher-pitched noise that usually changes with engine speed.)

Wind Noise (A "whoosh" type of noise)

Rhythmic Clunk, Bang, Tap or Squeal

Growl (A low sound, like an angry dog)

Knock (Like a knock on a door)

Hum (Like a wire humming in the wind)

Boom (A sound like a drum roll or distant thunder)

Boom (A sound like a drum roll or distant thunder)

Have any repairs been done recently? If so, please specify.

If the noise / vibration occurs in a specific instance and the above questions didn't describe it properly, please tell us how so we can try to recreate it to better identify the issue.

Phone

This field is for validation purposes and should be left unchanged.

Download Print Version – Noise Vibration Form

Drivability Concern

Name(Required)

First Last

Phone(Required)

Email(Required)

Vehicle Year(Required)

Vehicle Make(Required)

Vehicle Model(Required)

The issue occurs...(Required)

Always

Intermittent

Rarely

Are there Warning Lights On?(Required)

Yes

No

The issue occurs during...(Required)

First start of the day

After sitting a few hours

Light to medium acceleration

Hard acceleration

Cruising

Deceleration

Braking

Turning

When in 4WD

Air Conditioning on

Hot days

Humid / rainy days

Cold days

Very Cold Days

Please select all that apply.

Did the issue occur...(Required)

Suddenly

Gradually

Recently

Since I got the vehicle

After an abnormal occurrence (ex. pot holes, curb impact, etc.)

Other

Please check all that apply.

At what "engine" temperature does the issue occur?

Cold

Warm

Hot

Please check all that apply.

Does the engine "crank"?(Required)

Yes

No

Does the engine start?

Yes

No

If yes, how long does it take to start?

Starts Normal

Seems to take a bit longer

Cranks over for 10 plus seconds

Gas Pedal to the Floor

Is the vehicle equipped with a remote starter system?

Yes

No

Is the engine idle...

Rough

Unsteady

Low

High

Surging

Does the engine quit immediately after starting?

Yes

No

Please describe the vehicle's engine performance problem(s).

Hesitates or stalls on acceleration

Stalls on deceleration or quick stops

Lacks power

Misses under load

"Pings" or "knocks"

Backfires (popping noise)

Speed changes without touching accelerator

Check Engine Light Is Flashing

Other

Is the issue evident now?(Required)

Yes

No

Can you recreate the concern if required for the tech?(Required)

Yes

No

Does the issue occur when the gear is in...(Required)

P (park)

R (reverse)

N (neutral)

D (Drive)

Please select all that apply.

Did this happen shortly after something was done to the vehicle?(Required)

Yes

No

Have you done any repairs to try and correct this concern?(Required)

Yes

No

Additional Information if Required

Name

This field is for validation purposes and should be left unchanged.

Download Print Version – Drivabilty Form

Fluid Leak Concern

Name(Required)

First Last

Phone(Required)

Email(Required)

Vehicle Year(Required)

Vehicle Make(Required)

Vehicle Model(Required)

The leak occurs(Required)

Always

Sometimes

Rarely

When did you notice the concern?(Required)

Suddenly

Recently

Since a service or repair was done

Gradually

Since new

After an abnormal instance

Please check all that apply.

What colour is the fluid?

Red

Orange

Yellow

Green

Blue

Pink

Brown

Black

Clear

Unsure

Where do you think the leak is located?

Drivers Side Front

Passengers Side Front

Drivers Side Rear

Passengers Side Rear

Middle of Vehcile

Sunroof

Door

Front

Rear

Other

Do you have to add fluid?

Yes

No

Are there any warning lights on?

Yes

No

Have you done any repairs to try and correct this concern?

Yes

No

Comments

This field is for validation purposes and should be left unchanged.

Download Print Verison – Brake Form

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