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.

Please enable JavaScript in your browser to complete this form.

- Step 1 of 3

Workshop/Business Name *

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.

Hired/Leased? Registration (Optional)

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.