Corey’s Cars Mechanic Request Form

All sections must be completed for appointment to be confirmed

First Name:

Last Name:

Email:

Mobile Phone:

Home Phone:

Year:

Make:

Model:

Mileage:

Type of Service Requested

ACKNOWLEDGMENT AND CONSENT:

By checking this box, you expressly consent to receive customer care text messages and/or phone calls to the number provided from or on behalf of Corey's Cars or their employees in response to your inquiry. By opting in, you understand no mobile information will be shared with third parties or affiliates for marketing or promotional purposes. Message frequency varies per user. Message and data rates may apply. You may withdraw your consent at any time by texting "STOP" or "HELP" for help. See our Privacy Policy for more information.