PHB Customer Input
THANK YOU FOR COMPLETING THIS FORM! This allows us to better serve you by managing scheduling and preparing paperwork in advance of service. Customer data will not be shared with anyone for any reason except to resolve a dispute with a bank/creditor or unless legally compelled to do so by court order.
How did you hear about us? *
If by Referral, please indicate who referred you in "Other"
Select Desired Service: *
Required
Please select anticipated method of payment *
CHECKS ARE NOT ACCEPTED. This question is being asked to communicate our accepted payment methods. Regardless of your choice, you can pay with any method listed at the time of installation.
First Name *
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Last Name *
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E-mail address *
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Street Address *
Physical address for your receipt.
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City *
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Zip *
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Phone Number *
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Year *
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Model *
Your answer
VIN *
With your VIN, we can check dealer service history, confirm mileage, look for safety recalls and recommend additional maintenance. Your warranty is tied to your VIN.
Your answer
Have you checked Toyota service records for your VIN
http://www.toyota.com/owners Join Now, Add your year and model and add your VIN.
Mileage *
Your answer
Battery Condition and Possible Core Charge *
We can't get batteries cheaper than anybody else. Our ability to offer batteries at this price is only possible because the majority of customer cores can be reconditioned and used for future customers. If your battery is a recondition or has been tampered with in any way, you may be subject to a $600 core charge. Should the battery be recoverable, you will receive a full or partial refund of the core charge within 30 days. Please note that we never want to do this, BUT some of the workmanship we've seen demands it moving forward.
Vehicle history
e.g., original owner, 3rd owner, list any major work accomplished during ownership
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Length of ownership
Time and miles
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Region
Indicate region/state of origin if known, i.e., where has the car spent most of its life.
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Symptoms *
Please list any symptoms BESIDES warning lights, e.g., engine runs all the time, fan noise from back, power is down, won't start unless I unplug the 12V, etc.
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Which lights are on? *
Required
When was the 12V battery last replaced? *
A failing 12V can wreak havoc with the Prius. On rare occasions, it's the ONLY problem.
Your answer
If the car has been sitting for an extended period of time JUST PRIOR to this failure, please indicate how long below:
Extended periods of sitting (weeks to months) can contribute to both 12V and HV Battery failure.
Your answer
What is the battery gauge doing?
If you watch the battery meter, is it moving up and down quickly, always near the bottom, always charging, etc.
Is the cooling fan running?
An ailing battery will frequently run the cooling fan at full blast making you wonder what the heck is going on back there.
Has it been diagnosed at a dealer? *
Indicate yes/no or Auto Parts Store if you had codes read at an auto parts store.
Please list any codes given. *
Your answer
Do you know when your spark plugs were replaced?
We offer a maintenance package that includes new plugs, air filter with throttle body and MAF sensor cleaning for $150 inclusive.
Please indicate if you have problems with any of the following: *
The following items are common issues with the Prius, and PHB can offer repair or replacement during your battery installation appointment.
Required
DANGER! A PRIUS CAN BURN OIL! (see description) *
A high mileage Prius has a tendency to consume oil and is at risk for permanent damage if neglected. This is true particularly as it approaches 200,000 miles, but it can be an issue at any point over 100,000 miles. It is critical to keep the oil level between the marks on the dipstick and to NEVER overfill or under-fill the oil as permanent and expensive engine damage may occur.
Required
Comments/Notes
Please include any additional information you wish
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Appointment date and time: *
Please enter the appointment date we discussed.
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PERSONAL CHECKS AND CREDIT/DEBIT FEE! *
PERSONAL CHECKS ARE NOT ACCEPTED. There is a $3 convenience fee for every FULL $100 charged to credit card, AND debit is processed as credit.
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