Auto Shop Diagnostic Consent Form
Please review and sign to authorize the diagnostic service at Gatorback Towing and Auto Repair.
Customer Full Name
*
First Name
Last Name
Vehicle Information (Year, Make, Model)
*
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. 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
*
-
Month
-
Day
Year
Date
Submit Consent
Submit Consent
Should be Empty: