My Diagnostic Worksheet for Random Occuring Problems

Intermittent/Random problems can be a very frustrating experience for both the customer and the technician. To serve you better, please fill out the information below, and check off the appropriate boxes. If necessary, keep this form with you for a few days so the information needed will be fresh in your mind the next time the problem occurs.

1. CUSTOMER NAME

2. VEHICLE (year, make, model)

3. VEHICLE SYMPTOMS/DESCRIPTION (then see appropriate worksheet)

4. WHEN DID THE PROBLEM FIRST START HAPPENING?

5. HAS VEHICLE BEEN WORKED ON FOR THIS PROBLEM BEFORE?

____Yes _____No

If yes, what work was done? Did it make any difference?

6. DOES THE CAR HAVE PROBLEM WHEN THE ENGINE IS:

cold only

warm only

warm or cold

other:(describe)

7. DOES THE CAR HAVE PROBLEM WHEN WEATHER CONDITIONS ARE:

________cold only       _________hot only

________hot or cold     _________wet only

________dry only         _________no difference

8. HAVE YOU NOTICED ANY UNUSUAL SOUNDS?________, ODORS?_______,

DRIPS?_________, LEAKS?_________,SMOKE?________, WARNING LIGHTS?_____

GAUGE READINGS?_________

Explain______________________________________________________________

_____________________________________________________________________

9. ANY CHANGES IN ACCELERATION?_________, ENGINE PERFORMANCE?________,

GAS MILEAGE?__________, FLUID LEVELS?___________

Explain______________________________________________________________

_____________________________________________________________________

10. ANY PROBLEMS IN HANDLING?___________, BRAKING?_____________

STEERING?____________, VIBRATIONS?___________

Explain______________________________________________________________

_____________________________________________________________________

11. HOW OFTEN DOES THIS PROBLEM OCCUR:

________Every time vehicle is driven ______Once a day

________Once a week ________Randomly ________other (explain)_____

_____________________________________________________________________

12. WHAT IS THE LONGEST PERIOD OF TIME, IN NORMAL USE, DURING WHICH YOU DID NOT NOTICE THE PROBLEM:

________1 hour ________ 1 day

________1 week ________ other (explain)_____________________________

_____________________________________________________________________

13. OTHER HELPFUL INFORMATION: (check ALL that are appropriate)

_____ has vehicle been sitting for a long time? (If so, how long?) __________

_____ is vehicle normally garaged?

_____ is vehicle only driven short trips?

_____ has vehicle ever been in an accident? What parts were damaged? ___________________________________________________________

_____ has vehicle been stolen/recovered recently?

_____ has vehicle just been washed?

_____ have you ever noticed wet carpeting?

_____ has vehicle ever been in a flood?

_____ does vehicle have a salvage title?

_____ has the vehicle just had body work or other repairs?

_____ has a stereo or other accessory been recently installed?

_____ does the vehicle's radio have static?

_____ are there any electrical accessories that do not work? (please list) _______________________________________________________

_______________________________________________________

_______________________________________________________

_____ have you noticed any electrical abnormalities? (explain)

_______________________________________________________

_______________________________________________________

_____ did the problem happen shortly after a gas purchase?

_____ any recent changing of gas brand?

_____ any unusual raw gas smells?

_____ problem occur right after loaning car to someone else?

_____ has anyone else experienced the problem in your vehicle?

_____ does altitude seem to have any effect?

_____ does the temperature gauge ever show overheat?

_____ does the temperature gauge show very low temperature, even after driving for 20-30 minutes?

_____ does the heater take a long time to put out hot air?

_____ is vehicle equipped with any anti-theft device/alarm?

does it work? _______yes _______no

_____ does the vehicle have a hidden "kill" switch?

Any other information that you feel might be useful? ___________________________________________________________________________________________________________________________________________________________________________________

Copy and modify this worksheet as you see fit.