Complex Fault Diagnosis Form Please fill out each line with as much detail as possible. This will help us to help you. Name Email Phone Postcode Vehicle Make Model Year Pre 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 Registration Number Registration State NSW VIC WA NT SA QLD TAS ACT Fuel Source Diesel Petrol EV Hybrid Mileage Please Describe in Detail the Symptoms Frequency of Symptoms Permanent (always there) Every drive Once a day Once a week Once a month Has Another Workshop Looked at the Vehicle Already Yes No If Yes, Which Workshop and What Were Their Findings? Did Any Work Performed or Parts Replaced Improve or Reduce The Symptoms? Yes No If Yes, What Improved and How? Please List Any Fault Codes Given or Previously Extracted From the Vehicle Are There Any Additional Details You Would Like to Provide? Are There Specific Days That Work Better To Drop Your Car Off? Monday Tuesday Wednesday Thursday Friday Saturday Sunday How Long Can You Afford To Be Without Your Car For? 1 Day 2-3 Days 1 Week 1 Month 1 Month + Do You Require After Hours Pick Up Or Drop Off Of The Vehicle? Yes No Disclaimer Quicktech charges for diagnosis at our hourly rate of $145 per hour. The minimum charge is 1 hour and we will not exceed 2 hours without your consent. If a diagnosis is taking more than 2 hours, we will contact you before proceeding. You will be charged for time spent regardless of the outcome. At Quicktech we pride ourselves on accurate and timely diagnosis and we will liaise with you throughout the process. Please tick here to indicate your understanding and that you consent to this. Send