Every Visit Questionnaire - inMOTION Auto Care

Do you work from home?Yes
No
Retired
Student

Who is your employer?

How long have you had the vehicle for?

How long are planning on keeping the vehicle, time or mileage? (What are you looking to get out of this vehicle?)

What do you use the vehicle for?

How often is the vehicle driven?

How many miles are driven (average) per day?

Do you use this vehicle to tow?Yes
No

If yes for towing, please enter the approximate weight for vehicles commonly towed:

Does your vehicle have locking wheel nuts?Yes
No

Where is the key located?

Do you transport children on a regular basis in this vehicle?Yes
No

Is this your only vehicle?Yes
No

If no, please describe your other vehicles:

Has the vehicle been in an accident within the last 12 month?Yes
No

If yes, where was the damage and what was replaced?

What work has been completed on this vehicle since you've owned it?