R.Ex. - Exisiting Customers - Booking Form

NOTE: If you are a New Customer, Please use new customer form. This will allow us to set you up an account and organise billing for future jobs.

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- Step 1 of 3

Workshop/Business Name *

(Optional) Vehicle this

Purchase Order Number (Optional)

Job Contact Name (Your Name) *

First

Last

Job Contact Phone Number (Your Number) *

Please Include Area Code

Vehicle Year

Vehicle Make

Vehicle Model

Registration State *

Rego *

What Service Do You Require *

Any Other Useful Information (Optional)

Requested Date / Time Required (Optional)

Date

Time

Please Note: If left blank your job will be put into a queue.

What System Are You Using *

Is this an IAG Insurance Job? *

Have you also created a Remote Appointment on your Scan Tool? *

Video tutorial's attached for your convenience below.

Is this Tool System Hired/Leased? *

eg. Daily Hire from Chepa Auto Spares

Where this Tool was Hired From *

Repair Report (Optional)

Drag & Drop Files, Choose Files to Upload You can upload up to 5 files.