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Diagnostic Work Sheet

Description 

INTERVIEW SHEET SAMPLE 

Interview sheet
Customer name MR/MS Registration number   Initial year registration  
Vehicle type   VIN      
Storage date   Engine / Traction motor   Mileage km (Mile)
Symptom □ Does not operate (_____) function  
□? Warning lamp for (_____) turns ON.  
□? Noise □? Vibration  
□? Other (_____)  
First occurrence ?□ Recently □? Other (_____)  
Frequency of occurrence □? Always □? Under a certain conditions of ?□ Sometimes (time (s)/day)  
  □ Irrelevant
□ Fine □ Cloud □ Rain □ Snow □ Others (_____)    
□ Hot □ Warm □ Cool □ Cold □ Temperature [Approx. Deg. C (Deg. F)]  
□ High □ Moderate □ Low  
Road conditions □ Urban area □ Suburb area □ Highway □ Mountainous road (uphill or downhill) □ Rough road  
Operating condition, etc. □Irrelevant □When traction motor starts □ During idling □ During driving □ During acceleration □ At constant speed driving □ During deceleration □ During cornering (right curve or left curve) □ When steering wheel is steered (to right or to left)  
Other conditions    
Vehicle equipment
Memo