Please enter full name
Please enter current or vehicle registered address
Please enter CURRENT email
Please enter BEST NUMBER we can contact you at
Enter a second number if you like, ie. work..
We like to call to update you, but if you prefer text or email let is know.
Tell us of the problems you're experiencing, for example: sweeky brakes, or bumpy ride, or car wont start. Please tell us how long this has been happening and have you had any one recent repairs done to the vehicle.
I hereby grant Pak Auto Service and/or your employees permission to operate the vehicle described for testing and/or inspection, and acknowledge oral approval of an repair via phone, text or email. - PLEASE ENTER "I agree" IN THE SPACE PROVIDED.