Driveway Oil Change Intake Form

Full Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

E-mail*

example@example.com

What is your vehicle make and model?*

Service Selection- Oil Change include Oil Filter change*

Small Car (sedans,small coupe, compact Hatchbacks)-$60Large Car (SUV's and Trucks)- $75Add-On: Exterior Hand Car Wash - $20Add-On: Engine Air Filter Change- $20

Preferred Oil Type*

ConventionalSyntheticSynthetic BlendNot Sure- I trust your choice

Is there a safe, flat driveway available for service?*

YesNo

Preferred Service Day*

Preferred Time Window*

Morning (9AM-11AM)Midday (11AM-2PM)Afternoon (2PM-5PM)I need another time window- If selected, All Hands Company™ will review the request and contact you if an exception is approved

Any Special Instructions we should know?

(gate code, Specific car details, etc)

Agreement & Authorization (All checkboxes required to submit form)*

I confirm the information provided is accurate and that I am the property owner or an authorized representative of the property owner. I authorize All Hands Company™ to perform services at the address listed.I understand that All Hands Company™ will email my invoice and appointment details, and that service will be scheduled and activated only after payment is received. And that all sales are final unless otherwise stated.I understand All Hands Company™ and employees are not responsible for pre-existing mechanical issues, vehicle leaks or damages.I confirm the serviced vehicle is operable and safe to service.I authorize All Hands Company™ to perform oil change and/or car wash services at my propertyThe Client agrees to provide reasonable access to an active water source on the premises, at no additional cost, for the purpose of completing the requested services, if applicable, including but not limited to car washing or garbage bin cleaning.I acknowledge that service may be postponed or canceled if the driveway is unsafe or the vehicle is inaccessible.For the safety and protection of All Hands Company™ employees, I agree to secure all pets indoors and away from the service area during the scheduled service window. I understand that the services may be delayed, rescheduled or canceled if pets are not properly secured and All Hands Company™ is not liable for incidents involving unsecured pets.

How did you hear about us?

Driveway Oil Change Intake Form

Tell us about your vehicle