Check Engine Light Questionnaire

When did the light first come on? 1 Day
1 Week
1 Month
6 Month
Don't Know
Other

My Check Engine or Service Engine Soon LightIs on all the time (With key on - engine off & while engine is running)
Flashes on & off all the time
Flashes on & off intermittently
Is on intermittently (Can consistently reproduce under certain same conditions) consistently)
Is on randomly (Sporadic - can not reproduce consistently)

How often does it come on?Daily
Weekly
Monthly
Don't Know

Are there any other dash lights on?Yes
No

While Driving My Vehicle with the Check Engine Light On: (check all that apply)Runs Normal
Runs Rough
Engine Overheats
Misses (Vibrates)
Lacks Power(Sluggish)
Smokes Excessively
Stalls
Stumbles or hesitates (Dead spot on acceleration)
Has been on for a while with no drivability issues until recently

Have you noticed any oil consumption issues or fluid leaks?Yes
No

On the average, how many miles do you drive per day

When did you last fill-up the fuel tank?

E85Yes
No

How do you normally drive this vehicle?In town
Highway
Long idle times
Short trips

Has any repair work been performed within the last 12 month on this vehicle?Yes
No

Has any repair work been performed for this concern?Yes
No

Yes, record history of what was done when & by who in detail.