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Appointment Request Form
Address *
Preferred Contact Method *
Your driver’s side front window will be rolled down when the vehicle enters the shop. Please confirm that there is no known issue that might cause it to get stuck in the down position. *
Please tell us more about how you view the vehicles you own or lease. Finding out what is important to you helps us to serve you better. Creating a plan to address your vehicle’s needs tailored just for you saves you both time and money, while also conserving valuable resources.

Please tell us which statement best describes how you think about your vehicle (circle the appropriate number): *
Do you own or lease the vehicle brought in for service today? *
If you lease the vehicle, do you plan on buying it after the lease ends? *
Is this vehicle your primary source of transportation? *
Do you currently follow the factory maintenance schedule? *


I hereby authorize the repair work herein set forth to be performed along with the necessary parts and materials. I agree that Bock Auto is not responsible for loss or damage to the vehicle, or articles left in the vehicle, in case of fire, theft, or any other cause beyond their control. I hereby grant Bock Auto and/or its employees permission to operate the vehicle herein described on streets, highways, or elsewhere for the purpose of testing and/or inspection. An express garage keeper’s lien is hereby acknowledged on the above vehicle to secure the number of repairs thereto. All vehicles left over 24 hours after notification of completion WILL INCUR A $40.00 PER DAY STORAGE FEE. *