Parkway Automotive | Customer Information sheet

It is our Goal to make this the most comfortable and rewarding experience you’ll ever have at an automobile repair facility. In order to tailor our service to your specific needs, please take a few moments to complete the following questionnaire.

*

Mr.
Mrs.
Ms.
Miss.

Name: *

Spouse:

Address *

Apartment #

City *

State *

Zip *

Primary Contact #: *

Work

Mobile

Email (we will keep it completely private) *

Company (Commercial Customers - Please Enter Company Name.)

Our blog keeps you up to date on car care information. May we add you on our blog for a quarterly drawing for a gift worth at least $50?

Yes
No

If "Other" above, please explain.

Explain:

Is there anything about the car that does nor work or anything about the car we should know?
(i.e. don't roll down driver's window etc.) *

Do you have extended warranty on any of your vehicles? *

Yes
No

When was the last time someone serviced your car and what did they do?

I prefer to pay for automotive service by: *

Check
Credit Card
Cash
90 days Same as Cash Plan

YOU HAVE AUTHORIZED US TO SERVICE YOUR AUTOMOBILE.

This warranty covers material and labor for a period of 24 mo/24,000 miles, whichever comes first, unless otherwise stated on the repair order. This warranty starts from the date the work is completed and includes any defects in workmanship arising from repairs performed under the original invoice. It does not cover incidental or consequential losses such as towing, loss of earnings, per diem expenses, rental car expenses, or any other claims whatsoever. Parkway Automotive Services’ obligation under this warranty is limited to replacing or repairing damaged and/or defective parts and labor incurred in the performance of that task. If Parkway Automotive Services has not shown on your repair order that it specifically replaced or repaired an item, it is not covered under the warranty. Any damage caused by neglect, abuse, misuse, or collision is not covered by this warranty. This warranty is non-transferable and limited to the customer listed on the repair order.

Shop supplies are those miscellaneous items that are used in our shop which are too numerous to list. A sample list is posted in our office. Also included are hazardous waste fees that we now have to pay. Any vehicle left seven (7) days after completion will be subject to storage charges and will be subject to sale after thirty (30) days. You have authorized us to drive your vehicle for test purposes. We cannot be responsible for personal items left in your vehicle. All repairs must be paid in full before your vehicle is delivered.

Customer Signature (please type your name here)
*

NO REPAIRS DONE WITHOUT YOUR AUTHORIZATION
Thank you for your time and the opportunity to service all of your automobile repair needs.

At Parkway Automotive Services, “The Service Will Amaze You!”

Forms

Auto Repair Customer Information sheet