Rasch Service  ::  11149 Manchester Road  ::  Kirkwood, MO 63122  ::  314-821-3377

Drivability Worksheet

To provide a complete and accurate diagnosis of your vehicle, our mechanics need a thorough description of the problem. When you're done completing this form to the best of your ability, please print it out and bring it with you to your appointment. Thank you!

General Information
My vehicle's "Check Engine Light" is on:
Yes No  
When turning the starter, my vehicle:
Cranks normally Cranks slowly Will not crank
When starting, my vehicle:
Is difficult to start cold Is difficult to start hot Starts and dies
Starts normally Will not start
While idling, my vehicle:
Backfires Has fuel/gas odor Hesitates
Lacks power Pings (spark knock) Runs too cold
Runs too hot Smokes excessively Stalls when slowing/stopping
Vibrates excessively
Other Symptoms:
Transmission shifts too soon Transmission shifts too late Poor Fuel Mileage
Emissions test failure or "rotten egg" odor Other
If you checked "other", please explain.

Conditions of Occurance
Time of Occurance:
Evening Midday Morning
Night
Speed at occurance:
Acceleration Deceleration High Speed
Highway (cruise) Idle Low Speed
Stop and go
Distance at occurance:
Less than 2 miles From 2 to 10 miles More than 10 miles
Frequency of Conditions:
Always Intermittently After miles
Environmental Conditions:
Cold Weather Hot Weather Wet/Rainy
Snow Fog Dirt/Dust
Engine Conditions:
Engine Cold Engine Hot All Temperatures
When Shifting While Turning While Braking
With Headlights on With A/C on
Driving Habits:
Start cold engine, drive immediately Start cold engine, allow to warm up Mostly highway driving
Mostly city driving Park in garage
Type of Fuel Used:
87 Octane 89 Octane 91 Octane
Greater than 91 Octane