Request an Appointment
Client ID (If Known)
Contact Phone Number:
What type of appointment would you like to schedule?
**If scheduling a camera installation please use the Camera Appt. form to request your appointment
Installation (New Client)
If scheduling a vehicle transfer, please include all new vehicle information
Vehicle ID number (VIN); Year; Make; Model; Mileage; Color; Vehicle Owner
What service center location would you like this appointment at?
(Some appointments may require you to come to our Farmington Hills service center)
Farmington Hills (Main office)
Flint (Mon/wed/fri only)
Lapeer (Tues/Thurs only)
Ludington (must provide 72 hour notice)
Please select your preferred day or first available for the appointment:
What time of day would you like the appointment?
When is the best time to reach you to confirm this appointment or return your call?
If payment is required, please choose below how you would like to pay for this appointment:
Please refer to your Contract for a list of all fees. For existing clients having a camera installed, please refer to the Addendum emailed or mailed to you with pricing details
Debit/Credit Card over the phone
Pay Online at www.nationwideinterlock.com
Run credit card on file
Mail a check or money order (must be received prior to service)
Please list any additional information below that you wish to include for this appointment:
*Due to the upcoming law changes for the interlock device industry in Michigan, we are experiencing a high volume of calls and appointment requests. All calls and requests will be returned in the order they are received. Thank you in advance for your patience
Draeger Interlock 7000 w/Camera
*New model approved in the State of MI in 2016, available at select service center locations in Michigan
Draeger Interlock XT w/Camera
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