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New Client Contact Form — Gearhead Automotive

Thank You For Choosing Gearhead Automotive! Please Take A Minute To Confirm Your Details So We Have Everything Ready For Your Visit.

Primary Contact Info

Business Name (If Applicable)

Full Name

*

Cell Number

*

Alternate Number

May We Send You Appointment Updates And Reminders By Text?

*

A

Yes

B

No

Things Like Booking Confirmations And When Your Vehicle Is Ready. You Can Opt Out Anytime.

Email Address

*

Address

*

City / Town

*

Province

*

A

Alberta

B

Other

Postal Code

*

Optional Secondary Contact Info

In Case We Can't Reach You About Your Vehicle. Optional, But Helpful.

Secondary Contact Full Name

Secondary Contact Cell Number

Secondary Contact Email

A Few Last Details

How Did You Hear About Us?

*

A

Google Search

B

Google Maps

C

Facebook

D

Instagram

E

Gearhead Website

F

Referred By A Friend Or Family Member

G

Referred By Another Business

H

Drove By / Saw Our Sign

I

NAPA Autopro Website Or Network

J

Returning Customer

K

Other

How Long Do You Plan To Keep This Vehicle?

A

As Long As It Runs — I'd Like 300,000 km Or More Out Of It

B

A Few More Years

C

Less Than A Year — Planning To Replace It Soon

D

Not Sure Yet

This Helps Us Recommend The Right Maintenance For Your Plans — Not Just What The Manufacturer's Warranty Schedule Says.

How Do You Feel About This Vehicle?

A

I Like It — Worth Keeping In Good Shape

B

It's Fine — Fix What's Needed

C

I'd Rather Replace It Than Put Money Into It

Is Your Vehicle Equipped With A Remote Start?

A

Yes

B

No

C

Not Sure

Is Your Vehicle Equipped With An Aftermarket Alarm?

A

Yes

B

No

C

Not Sure

Where Is Your Wheel Lock Located? (If Applicable)

Your Wheel Lock Key Is Often In The Glovebox, Center Console, Or Trunk. Leave Blank If Not Applicable.

Closing

Your Personal Information Will Never Be Disclosed To Anyone Outside Of Gearhead Automotive Services Ltd. Your Email Is Used Mainly For Written Authorizations And Sending Inspection Reports.