Auto Shop Diagnostic Consent Form

Auto Shop Diagnostic Consent Form

Please review and sign to authorize the diagnostic service at Gatorback Towing and Auto Repair.
Customer Full Name

First NameLast Name
Vehicle Information (Year, Make, Model)
Email
example@example.com
Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Diagnostic Fee: I authorize Gatorback Towing and Auto Repair to perform a diagnostic evaluation on my vehicle. I understand the diagnostic fee is $125.00 for up to one hour (VOA $115.00). Additional repairs or services will not be performed without my consent.
Standard Disclaimers:
- The diagnostic fee is non-refundable and covers only the initial assessment.
- Additional time or repairs may incur further charges, subject to customer approval.
- Gatorback Towing and Auto Repair is not responsible for unforeseen issues discovered during diagnosis.
- I acknowledge that I have read, understand, and agree to the terms above.
Customer Signature
Date

MonthDayYear
Date
Should be Empty: