Please open and fill out the following information to book your appointment.

COVID-19 Health Declaration

Have you been in close contact or casual contact with a person with suspect, probable or confirmed
infection of novel coronavirus in the 14 days before the onset of your symptoms?
YesNo
If Yes, please provide dates of contact

Booking Information

Vehicle Registration Number*
Please enter your vehicles registration plate.

Vehicle Make/Model/Year*
Please enter the Make, Model and Year of your vehicle.

Contact Details
Please enter the contact details of the person who we should contact and is authorised to make decisions and pay the bill for the vehicle
First Name*

Last Name*

Mobile phone*

Home or Business Phone

Email*

I am an existing customer

What type of work do you need to be done? (select one or more)*
If unsure, select "General Repairs" and tell us more about the work you want to be done
Warrant of FitnessWarrant of Fitness RecheckWarrant of Fitness RepairsGeneral RepairsDiagnosticsPre Purchase InspectionPremium ServiceStandard ServiceBasic ServiceHybrid electronic diagnostic test (includes road test and analysis)
(for Service details please see Car Servicing)

If you have a WoF sheet detailing required repairs please either upload the files (gif, png, jpg, pdf, 10MB limit), email the files to office@grimmermotors.co.nz, or leave them on the passengers seat

Have you or anyone else worked on this issue with your vehicle?*
YesNo

Who will be paying for this work?*
---MeMotherFatherRelativeFriendBusinessInsuranceOther

Contact Method when vehicle is ready?*
How would you like us to contact you when your vehicle is ready to be picked up?
---Please call my mobile when vehicle readyPlease call my landline when vehicle readyPlease txt me when vehicle is readyPlease email me when vehicle is ready

Preferred Booking Date*

Due to delays in sourcing parts during this time, it is ideal if you can leave your vehicle with us all day.

Please drop the car off after 7:30am and pickup by 5:00pm while mechanics are at work.

When you get the work done at Grimmer Motors, and leave your car from at least 8.30am to 2.30pm you get these FREE extras:
(Uncheck any you don't desire)
Basic Car WashVacuumTyre ShineDash Polish

When will you be dropping your vehicle off?*
---7:308:008:309:009:3010:0010:3011:0011:3012:0012:301:001:302:002:303:003:304:004:305:005:30

Can you leave your car with us for longer than one day?
---Need the car back same dayCan leave overnightI can leave for 2 or more days

What is the latest time you can pick it up?*
---7:308:008:309:009:3010:0010:3011:0011:3012:0012:301:001:302:002:303:003:304:004:304:45

Did you speak to anyone at Grimmer Motors?*
---SonyaSusanChrisRaghuCallumHaven't spoken to anyone yetI spoke to a male but can't remember their nameI spoke to a female but can't remember their name

Your Electronic Signature

Your signature to confirm you agree to the terms and conditions listed above,
as well as having filled out the form truthfully and to the best of your ability.
By typing your full name into the box below, you agree that this is your Electronic Signature,
the same as if you were handwriting your signature