Driveability Worksheet

To provide a quick, complete and accurate diagnosis of your vehicle our technicians need a thorough description of the problem. Please take a few minute to complete this worksheet to the best of your ability. The information you provide will be a tremendous aid to the technician.

Vehicle Information

Date:	Name:		Invoice No:
Year:	Make:	Model:		Engine:
Mileage:		VIN:

Driveability Symptoms

Please check all symptoms that apply to your vehicle

My vehicle's "CHECK ENGINE" light

¨ Glows steadily

¨ Glows intermittently

¨ Never comes on

While operating the starter, my vehicle

¨ Will not crank

¨ Cranks slowly

¨ Cranks normally

When starting, my vehicle

¨ Will not start	¨ Starts normally
¨ Starts and dies	¨ Is difficult to start:	¨ Hot	¨ Cold

While Idling, my vehicle

¨ Will not idle	¨ Idles too low	¨ Idles too high
¨ Idles rough
¨ Surges (up and down)
¨ Backfires
¨ Idles normally

While driving, my vehicle

¨ Backfires
¨ Pings (Spark knock, detonation)
¨ Smokes excessively	¨ Runs too hot	¨ Runs too cold
¨ Black	¨ Blue	¨ White
¨ Has a fuel or gas odor
¨ Hesitates	¨ Stumbles	¨ Stalls	¨ Surges
¨ Lacks power (sluggish)	¨ Misses	¨ Cuts out
¨ Stalls when slowing or stopping
¨ Vibrates excessively

Other symptoms

¨ Transmission shifts	¨ Too soon	¨ Too late	¨ Normally
¨ Poor fuel mileage
¨ Emissions test failure or "rotten egg" odor
¨ Other (Please explain)

Conditions of Occurrence

Time:	Speed:	Distance:
¨ Morning	¨ Idle	¨ Less than 2 miles
¨ Midday	¨ Low speed	¨ From 2 to 10 miles
¨ Evening	¨ Stop and Go	¨ More than 10 miles
¨ Night	¨ Highway (Cruise)
	¨ High speed	Conditions:
	¨ Acceleration	¨ Uphill
	¨ Deceleration	¨ Downhill

Frequency of Conditions

¨ Always	¨ Since New
¨ Intermittently	¨ After_______ miles

Environmental conditions

¨ Cold Weather	¨ Wet/Raining	¨ Fog
¨ Hot Weather	¨ Snow	¨ Dirt/Dust

Engine Conditions

¨ Engine Cold	¨ While Turning
¨ Engine Hot	¨ While Braking
¨ All Temperatures	¨ With Headlights ON
¨ When Shifting	¨ With A/C ON

Driving Habits

¨ Start cold engine and drive immediately

¨ Star cold engine and allow to warm up

¨ Mostly highway driving

¨ Mostly city driving

¨ Park in garage
Average miles driven per day_____________

Fuel Quality

Type of fuel used______________________
Octane rating	¨ 87	¨ 89	¨ 91	¨ Greater than 91
Brand of fuel_______________________________
Last fill-up date_____________Miles____________