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State / Province / Region
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Afghanistan
Albania
Algeria
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Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia (Plurinational State of)
Bonaire, Saint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Congo (Democratic Republic of the)
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Kingdom of)
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran (Islamic Republic of)
Iraq
Ireland (Republic of)
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea (Democratic People's Republic of)
Korea (Republic of)
Kosovo
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia (Federated States of)
Moldova (Republic of)
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia (Republic of)
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine (State of)
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin (French part)
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten (Dutch part)
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syrian Arab Republic
Taiwan, Republic of China
Tajikistan
Tanzania (United Republic of)
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
Uganda
Ukraine
United Arab Emirates
United Kingdom of Great Britain and Northern Ireland
United States Minor Outlying Islands
United States of America
Uruguay
Uzbekistan
Vanuatu
Vatican City State
Venezuela (Bolivarian Republic of)
Vietnam
Virgin Islands (British)
Virgin Islands (U.S.)
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
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Business Phone Number
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Invoicing Email
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Additional Email
Any additional emails that need to be CC’d? (eg. Reports, invoicing etc) Leave blank/skip if not required
Additional Email 2
Any additional emails that need to be CC’d? (eg. Reports, invoicing etc) Leave blank/skip if not required
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Job Number / Purchase Order Number:
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Technician/Job Contact
Name
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First
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Mobile Number:
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Vehicle Information
Make
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Abarth
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Model
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Information Report made
Model Code
Manufacture Year
*
Picture of VIN Plate
*
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Capture With Your Camera
You can upload up to 4 files.
Camera Preview
Registration Plate
*
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Service/s Required
Select All Service/s Required
*
Gateway Unlock
New Module Coding
Calibration
Scan
Technical Assistance
New Module Coding
*
Front Radar
Blind Spot - Passenger Side
Blind Spot - Driver Side
Headlights
Airbag
Steering Rack
Engine
Transmission
Instrument Cluster
Front Lane Departure Camera
Parking Sensors - Front
Parking Sensors - Rear
Seatbelts
Steering Column
Front Corner Radar - Passenger Side
Front Corner Radar - Driver Side
Calibration
*
Front Radar
Corner Radar
360
BSM
Parking Sensors
Lane Departure Warning
Laser Scanner
Reverse Camera
Scan
*
Pre-Scan
Post-Scan
Diagnostic Scan
Technical Assistance
(Please Be as Detailed as possible. The more detail you can provide, faster we can understand all factors and help you)
Customer’s Complaint
*
Describe Issue in full
*
What diagnostics/Repairs have been carried out up until now?
*
When did the issue first occur?
*
Any Aftermarket Accessories/Modifications
Yes
No
eg Bullbar, Lifted or Lowered, Canopy/Tray Back
Select All Aftermarket Accessories/Modifications That Apply
Lift Kit
Lowered
Bullbar
Towbar
Aftermarket Canopy/Trayback
Larger Tires/Rims
Pre-Scan Report
*
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Capture With Your Camera
You can upload up to 5 files.
Camera Preview
Upload a Single PDF or Screenshots of each page (We prefer a PDF)
Job/Repair Sheet (All Pages)
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You can upload up to 6 files.
Camera Preview
Pictures/Screenshots of ALL pages please
Pictures of Vehicle/Issue Area
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Capture With Your Camera
You can upload up to 10 files.
Camera Preview
Pictures can tell a thousand words. Please attach any useful pictures of area of concern (Any detail photos eg radar mounted, suspect wiring, etc)
Next
Connection Tool Appointment Creation
Tool/Remote Connection System
Launch (SmartLink Remote Diagnose)
Autel (Remote Expert)
Have you now made an appointment on Launch SmartLink Remote Diagnose?
*
Yes
Please create this appointment NOW before proceeding further with this booking
Have you now made an appointment on Autel (Remote Expert)?
*
Yes
Please create this appointment NOW before proceeding further with this booking
Next
Supporting Information & Attachments
Accident/Crash Information
What happened to this car? eg. Area/s of impact
What’s Been Removed, Repaired, Re-installed or New
Please be as detailed as possible eg. (Front bar removed, radar bracket was bent, new radar fitted, new bumper painted and reinstalled)
Any Other Useful Information?
What have you tried already?
Job/Repair Sheet (All Pages)
Drag & Drop Files,
Choose Files to Upload
, or
Capture With Your Camera
You can upload up to 5 files.
Camera Preview
Upload a Single PDF or Screenshots of each page (We prefer a PDF)
Pictures of Vehicle/Issue Area (Pre-Repair)
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Choose Files to Upload
, or
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You can upload up to 5 files.
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