Quick & Easy Auto Repair First Time Service Pass Non-Member Service Intake, Agreement & Disclaimer

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This form is required to redeem your $75 Labor-Free Service Coupon and helps us track service usage and membership savings. Must match payment name.

By completing this form, you are requesting mobile diagnostic, maintenance, or repair services from Quick & Easy Auto Repair as a non-member. Submission of this form confirms your acknowledgment of non-member service terms, payment authorization, liability disclaimers, and mobile service access requirements.
Non-member services are subject to availability, are not prioritized over members, and are not confirmed until payment or required deposits are received. Diagnostic and service fees apply regardless of repair approval and are non-refundable.
Please complete all sections accurately. Submission acts as your digital agreement and authorization to proceed.

Email *

Home of South Florida Elite Mobile Mechanics

First Name *

Last Name *

Phone Number *

Email Address *

Preferred Contact Method for Service Updates *

Phone Call

Text Message

Service Address *

City *

State *

Zip *

Have you previously used Quick & Easy Auto Repair services? *

Yes, as a member

Yes, as a non-member

No, this is my first time

Approximate date and time for preferred service visit *

YYYY

Time

Preferred Service Time Window *

Select the time of day when you prefer service to be performed.

Morning (6 AM – 10 AM)

Afternoon (10 AM – 2 PM)

Evening (2 PM – 6 PM)

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