Service Request Intake Questionnaire
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Preferred Contact Method
*
Call
Text
Email
Either
What are your service needs today?
*
One Time Repair or Service
Preventative Maintenance Plan Enrollment
Not sure / need diagnosis
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Trailer Information
Trailer Type
*
Please Select
Horse Trailer
RV / Travel Trailer
Utility Trailer
Equipment Trailer
Cargo / Enclosed Trailer
Boat Trailer
Other
Number of Axles
Please Select
Single Axle
Tandem Axles
Triple Axles
Not Sure
Trailer Year / Make / Model (if known)
Example: 2017 Big Tex 14LP
VIN (or last 8 digits, if available)
Helps identify axles and parts faster
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SERVICE REQUESTED
What needs attention? (check all that apply)
*
Bearings / Hubs
Brakes
Tires / Balancing
Electrical / Lighting
Suspension / Axles
Jack / Coupler / Hitch
General Maintenance
Not Sure - Diagnosis Needed
Other - Describe Below
Other Services Needed:
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PREVENTATIVE MAINTENANCE PLAN REQUEST
Which maintenance plan are you interested in? **Visit www.onthegotrailerservice.com for breakdown of each maintenance plan**
Basic Safety Plan - External bearing condition assessment (no hub removal), brake function check, tires, lights, breakaway test ($468.00 per year / per trailer)
Standard Maintenance Plan (Most Popular) -Full bearing repack, brake inspection/adjustment, suspension & electrical service ($828.00 per year/ per trailer)
Premium Fleet Care Plan - Multi-visit annual service, bearing & brake service, electrical, records per trailer ($1,188 per year / per trailer)
Not sure - Contact me for explanations
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You Chose Basic Safety Maintenance Plan:
**WHAT YOU GET** Includes (2 visits per year): • External bearing condition assessment (no repack) • Brake function test & adjustment • Tire inspection & pressure set • Lug nut torque check • Full lighting & wiring inspection • Breakaway system test • Safety condition report Subscriber Perks: • Priority scheduling • 10% off labor • Reduced service call ($50)
Is the Basic Safety Maintenance Plan what you wanted?
*
Yes
No
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You Chose Standard Maintenance Plan:
**WHAT YOU GET** Includes (2 visits per year): • Full bearing repack (once per year) • Brake inspection & adjustment • Tire rotation (if applicable) • Tire balance check • Suspension & lug torque check • Lighting & wiring service • Breakaway battery test • Detailed condition report Subscriber Perks: • Priority scheduling • Reduced service call ($25) • 15% off labor • Emergency service availability
Is the Standard Maintenance Plan what you wanted?
*
Yes
No
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You Chose Premium Fleet Care Plan:
**WHAT YOU GET** Includes (3 visits per year): • Annual bearing repack • Mid season brake & bearing inspection • Pre season tire inspection & balance • Electrical & lighting service • Breakaway battery replacement (battery included up to $40) • Maintenance records per trailer Fleet Perks: • No service call fee • Same week scheduling • 20% off labor • Priority emergency response
Is the Premium Fleet Care Plan what you wanted?
*
Yes
No
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PHOTOS (Please Submit)
Upload photos (strongly recommended)
Browse Files
Drag and drop files here
Choose a file
Helpful photos may include:• Hub face• Axle tag or sticker• Brake backing plate• Wiring or lights• Tire sidewall ***Photos help us bring the right parts and give faster estimates***
Cancel
of
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LOCATION AND ACCESS
SERVICE LOCATION (Where the Trailer is Located)
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Is the trailer in a safe, accessible location for mobile service?
*
Yes
No (Explain Below)
Explain:
Any other Access Notes:
Gate code, pets, parking restrictions, property contact, etc.
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URGENCY AND SCHEDULING
How urgent is this service?
*
Same day (if available)
Within a few days
Flexible
Trailer not safe to tow
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AUTHORIZATION & EXPECTATIONS
Must Select All:
*
I understand estimates may change after inspection
I authorize safety-related recommendations if issues are found
I understand repairs and parts are quoted separately
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FINAL NOTES
Anything else we should know about:
Service_Category
Maintenance_Tier
Inspection_Depth
Estimated_Labor_Range
Parts_Confidence_Level
Urgent_Class
CONST_Bearings_Hubs
CONST_Brakes
CONST_Tires
CONST_Suspension_Axles
CONST_Jack_Coupler_Hitch
CONST_Electrical
CONST_General_Maintenance
CONST_Diagnostic
CONST_Basic_Safety
CONST_Standard_Maintenance
CONST_Premium_Fleet
CONST_Not_Sure
CONST_Non_Invasive
CONST_Full_Service
CONST_Diagnostic_Scope
Submit
Should be Empty: