Office Unit 18 Anglo Business Park Aylesbury Bucks HP19 8UP Email Address: workshop@staautogearbox.co.uk Tel (01296) 481145 VEHICLE DIAGNOSIS SUBMISSION Your Name: Your Address: Contact Details: Vehicle Details Fuel Type Petrol Diesel Fluid Have you checked the fluid level? Yes No What was the fluid level? Please select High Low Not on dipstick Ok Is the fluid... Please select Clean Dirty (black) Burnt (smells cooked) Engine: Is the engine performing correctly or is it... Please select Low on power Not running correctly Ok Gearbox Is the gearbox noisy? Yes No Is it noisy when the car is... Please select Stationary In gear Moving Ok Is the noise at road speed? Please select Yes Faster Slower Does the problem occur when the gearbox is... Please select Hot Cold All the time Changing up Changing down Is the gearbox Please select Slipping Not Changing Gear Staying in 1st Staying in 2nd Staying in 3rd Staying in 4th Staying in O/D Is the problem intermittent Please select Yes No Unsure Electronics Is there any warning icons showing on the dash, if so, which ones? Have you had the vehicle checked on a diagnostics machine? Yes No Please list the codes and any additional information during the check