Bella Sez!

APPOINTMENTS

You can request an appointment by completing this form. When we receive your request, we will call or email you to confirm your appointment, answer questions, and provide estimates of potential costs.

You can also request an appointment by calling us at (503) 234-2119 or by emailing us.

When requesting an appointment, please take a moment to fill out our Symptoms Description Form, to aid us in quickly diagnosing your car's repair needs.

I am a  first time customer previous customer
Name: 
 First:    
Last:
Address: 
 Street:  
City:   State: Zip: 
Day Phone: 
 Evening Phone:
Cell Phone: 
   FAX: 
E-Mail: 
 

I prefer to be contacted via: Email   Phone   Other:


  
Automobile
Info:
   Year: Make:
Model:
Color: 
License Number:
Service Needed:
Pre-Purchase Inspection
Post-Purchase Inspection
Oil, Lube, Filter Change
Lube Only
Brake Repair/Inspection
Cooling System Analysis
Cooling System Flush
MaintenanceTune-Up
Exhaust System Repair 		Charging/Starting System Inspection
Accessories/electrical analysis/repar
Transmission Service
Clutch Repair/Inspection
Lighting Repair
AC/heating analysis/repair
Driveability checks
DEQ/DOE emissions failure 
(be sure to bring failure report.)
Other inspection or repair
OR
Manufacturer's Recommended Maintenance: miles
Other services (describe):
Describe any problem as best as you can:
Schedule: 
 When would you like to have your automobile serviced:
Comments: 
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you see in the picture at left:

 
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