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1
What car problem are you having?
Transmission
Engine
Electrical
Other Issue
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2
How many times have you taken your car to the dealership for repair?
3 +
2
1
0
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3
What year is your car?
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015 or older
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4
What's the Make and Model of your car?
Toyota
Audi
Chevrolet
Chrysler
Dodge
Ford
GMC
Honda
Hyundai
Jeep
Kia
Lexus
Mercedes Benz
Nissan
Subaru
Tesla
Volkswagen
Others
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5
In what state did you get your car from?
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Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Please Select
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
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6
What is your name?
First Name
Last Name
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7
What is your email?
example@example.com
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8
What's the best phone number to reach you directly?
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