East Amazon Auto Repair

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	Voice: (541) 485-2819

Phone
541-485-2819

Appointments

To request an appointment online...

...Simply fill in the form below and select which services you would like for us to perform on your vehicle. Be sure to click the 'Submit' button at the bottom of the page when you have completed filling in the form. One of our staff will contact you as soon as possible to confirm your appointment.

Thank You!

Your Information:

New customer?

Name:

Address:

City:

State:

Zip:

Daytime Phone:

Evening Phone:

Other Phone:

E-Mail:

FAX:

Contact me by:

Your Vehicle:

Year:

Make:

Model:

Color:

License Number:

Services Needed:

Pre-Purchase Inspection Inspection for Repair Diagnostic Tune-Up Oil, Lube, Filter Change Oil Leaks Adjust Brakes Brake Repair Maintenance Tune-Up	Cooling System Flush Exhaust System Repair Charging System Inspection Fan Belts Transmission Service Replace Clutch Repair Lights Alignment

Manufacturers Recommended Maintenance: miles

Other services (describe):

Please describe any problems you are experiencing:

When Would You Like To Schedule Your Vehicle:

Day:	Month:	Date:


Preferred Time:
	Dropoff:	Wait:

Additional Comments:

Please feel free to add any additional comments:

We will call or e-mail to confirm your appointment. Please remember, this is just a request for an appointment until we contact you.

Please click Submit only once

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