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50 Roy Blvd, Brantford,

ON N3R 7K2

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(519) 759-3769

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50 Roy Blvd, Brantford, ON N3R 7K2

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(519) 759-3769

MAKE AN APPOINTMENT

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Home
About Us
- Blog
- Directions
- Warranty
Nexdrive
EV & Hybrid
Carbon Cleaning
Digital Inspection
Services
Vehicles
Reviews
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Contact Us
- Forms

Fluid Leak Concern Worksheet

Name:

Phone:

Email:

Vehicle Details - Year / Make / Model*

The Leak Occurs

Always

Sometimes

Rarely

When did you notice the concern?

Suddenly

Since a service or repair was done

Since New

Recently

Gradually

After an Abnormal Instance

What abnormal instance caused the issue?

What color is the fluid?

Red

Yellow

Blue

Brown

Clear

Orange

Green

Pink

Black

Unsure

Where do you think the leak is located?

Drivers Side Front

Middle of Vehicle

Rear

Passengers Side Rear

Front

Drivers Side Rear

Door

Passengers Side Front

Sunroof

Other

Do you have to add fluid?

Yes

Are there any warning lights on?

Yes

Have you done any repairs to try and correct this concern?

Yes

Thank you for contacting us.
We will get back to you as soon as possible.

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50 Roy Blvd, Brantford, ON N3R 7K2

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(519) 759-3769

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Fluid Leak Concern Worksheet﻿

Fluid Leak Concern Worksheet

Fluid Leak Concern Worksheet