Survey Form -- Trip to the Repair Shop
This is just a sample of the survey form. The actual form can only be accessed using an encoded link within an email TrueDelta sends to the owners of surveyed cars.
Fill out this survey each time your car requires a repair.
Trip 1 since July 1st - your car***Complete this top section for only one repair trip at a time*** |
| 1. Odometer, end of July, nearest 1,000 |
| ,000 miles |
| 2. Month the trip ended? |
| July August |
| 3. Who did you take the car to? |
| Dealer Other shop Self / other non-mechanic |
| 4. Did the car have to be towed? |
| No Yes |
| 5. Did the trip also include maintenance, wear items, or "mods"? --wear items listed in the sidebar |
| No Yes |
| 6. Amount the car owner paid for repairs --for entire trip, not per problem --do not include maintenance or wear items (list in sidebar) --best guess okay, exact amounts not necessary --no idea? enter -1 (negative one) --numbers only, no currency symbols or words |
| 7. Number of working days in the shop |
| days (if self-repaired, enter hours instead of days) |
If the repair work took one hour or less, select zero days. Count every day the shop was open, up to the day repair work was completed. |
Problem 1, Trip 1 since July 1st - your car***Complete this bottom section for only one problem at a time*** Check the list of wear items in the sidebar. These never count as problems. |
| 1. Was Problem 1 old or new? |
| Old problem written up during
an earlier repair trip --but not successfully repaired, for whatever reason, during that trip |
| New problem |
| 2. How was Problem 1 first discovered? |
| Recall notice |
| TSB (Technical Service Bulletin) |
| Preventive maintenance -- no signs of failure yet |
| Check Engine Light or other warning light came on |
| Mechanic discovered problem when car in shop for something else |
| The person who usually drives the car noticed the problem |
| Friend or family member of the usual driver noticed the problem |
| 3. Source of Problem 1? |
| Present at new car delivery -- manufacturing defect |
| Damaged during shipping or on dealer lot --includes incomplete dealer prep |
| Damaged by repair shop |
| None of the above (most common) |
| 4. Could the car have been dependably driven for another week with Problem 1? |
| No Yes |
| 5. Outcome for Problem 1 during Trip 1? |
Unsuccessful (problem back within a week) or incomplete outcomes: |
| Parts ordered but not installed --separately report another trip to install parts after it happens |
| Told not a problem, "could not replicate," or "they all do that" --includes reset warning light or replaced a fuse if nothing else done |
| Decided not to repair for cost or other reasons -- living with problem |
| Got rid of the car without repairing this problem |
| Shop admitted problem exists, but did not or could not fix it --includes unsuccessful repairs |
Successful outcomes, repair successful after: |
| Updated software with reflash -- and nothing else |
| Cleaned, lubed, aligned, reattached, etc. -- no parts replaced |
| Parts replaced |
--consider a repair "successful" if the problem did not return within a week |
| 6. Who paid at least half of the cost of repairing Problem 1? |
| No repair, so no payment |
| Original warranty |
| Extended warranty, including certified |
| Manufacturer out-of-warranty assistance |
| Dealer or shop (usually because they caused the problem) |
| None of the above -- car owner paid over half of the cost |
| 7. System Repaired (if unsure, just select "everything else.") |
Powertrain |
| Computers and sensors - engine, transmission, and drivetrain |
| Engine: fuel, ignition, intake, and emissions systems; also accessory drives |
| Engine cooling system (radiator, water pump, thermostat, heater core, etc.) |
| Exhaust and catalytic converter |
| Engine, other than above |
| Transmission and drivetrain, except computers and sensors |
Chassis |
| Steering and suspension |
| Brakes, except pads, rotors, drums |
| Brakes: pads, rotors, or drums |
HVAC |
| Air conditioning and ventilation |
Electrical |
| Motors for windows, seats, etc. |
| Audio / video / nav |
| Light bulbs - headlight or took more than five minutes to change |
| Electrical, other than above |
Other |
| Rattles, squeaks, wind noise |
| Water leaks |
| Interior trim, except rattles and squeaks |
| Paint or other exterior cosmetic issue |
| Everything else |
Briefly describe Problem 1 of Trip 1Characters remaining: |
