Appointments
Please complete this form if you would like to make an appointment for service or to simply ask us a question.
*
indicates required fields
Are You A New Customer:
Yes
No
*
Which Location Will You Be Visiting:
Melrose Park
Lake In The Hills
*
First Name (required):
*
Last Name (required):
Address:
*
Home Phone:
Work Phone:
Cell Phone:
Which Number Should We Try First?:
Home
Work
Cell
E-Mail:
I Prefer To be Contacted Via:
Phone
E-Mail
Vehicle Year:
Vehicle Make:
Vehicle Model:
License Number:
Mileage:
Service Needed:
Oil, Lube, Filter Service
Brake Repair
Exhaust System Repair
Maintenance Tune-Up
Service Engine Light Diagnostic
Charging System Inspection
Inspection For Repair
Steering & Suspension Service
Serpentine Belts
Failed Emissions Repairs
Manufacturers Recommended Service:
Please (Check) Then Enter Mileage
If Service is Not Listed, Please Describe:
Please Call Me With An Estimate:
Check Here For Us To Call Before Service
I Authorize Service of Vehicle
I Authorize Work Up To The Amount Of $:
If you have any questions please email us at marcomuffler@yahoo.com
Home
|
Services
|
Specials
|
Locations
|
Appointments
©Marco Discount Muffler & Brakes, Inc.
Site Map