Tire Service Request

Are you a Tire Assist Club member?*

YesNo

Is this service request for a vehicle covered under your membership plan?*

YesNo

Note: Only vehicles covered under your membership are eligible for member benefits. For non-covered vehicles, standard service charges will apply.

Choose a convenient time for your service.*

What service do you need?*

Service Call

This non-refundable fee covers dispatch and travel. Refundable only if canceled at least 2 hours before the appointment.

$65.00 Quantity

Tires Services

Tire repair

Small punctures on the tread. Sidewall damage cannot be repaired.

$70.00 Quantity

Spare Tire installation

Spare tire provided by customer.

$70.00 Quantity

Tire Replacement

Tire cost not included. Please call for tire availability.

$70.00 Quantity

All 4 Tires Installation

Whether you buy the tires from us or elsewhere, we can install them for you at your location. (Tires not included)

$180.00

Roadside Assistance

Jumpstart

Car battery not included.

$30.00 Quantity

Car Lockout

No key duplication.

$30.00 Quantity

Gas Delivery

3 gallons of regular gas.

$15.00 Quantity

Total

$0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Full Name*

First and Last name

Contact Phone Number*

Please enter a valid phone number.

Email Address*

example@example.com

Assistance Needed At

Street Address

Street Address Line 2

CityState

Zip Code

Assistance Location Description

Example: Parked on the road in front of the blue building. (Please add dropped pin if available)

Vehicle Information*

Color/ Year/ Make/ Model

Tire size (if available)

This can be found on the tire or on the driver's door sticker.

What Member Service do you need?

Please briefly explain the situation.

Example: I have a nail in my tire that needs to be repaired.

Add a picture of your damaged tire (Optional)

If you need a new tire, please call us to verify tire availability and pricing before continuing. Pricing will vary based on tire size, brand, and type. We want to ensure the right tire is ready for your appointment.

Call us at (832) 829-6790