Repair Work Order Form
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Company Name
*
Company Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Type of service required
*
Module Repair
Diagnostics
Programming
Vehicle Identification Number (VIN)
*
Codes: please include full alpha-numerical code with module that is was retrieved from
*
example: P0300 pcm
Brief description of the problem
*
Upload VIN (Taking picture of the door jamb label works well)
Upload Screenshots of the Problem (if applicable)
I agree to terms and conditions
*
I understand that all services rendered will be paid in full at time of completion or delivery
I agree to terms and conditions
*
I understand that all modules not previously diagnosed by M-Tekk will have a diagnostic fee not exceeding $150.00
Submit
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