Jensen's Car Tech - Request Service

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Fill out the form below to request service. All fields required.

THIS IS A REQUEST ONLY. We will confirm actual time & date of appointment via email. If you don't receive an email
within 24 hours to confirm appointment, please call us at 515-232-8809.

Personal Information

Please enter your name, phone number and email address.

First Name:

Last Name:

Phone:

Email:

Description of Service

Please enter the Year, Make & Model of your vehicle and describe the service or issues you are having

Please be as specific as possible when describing the vehicle issues.

Year:

Make:

Model:

Color:

Description/Problem:

Available for Service

Please enter date and time you would like the service to take place.

**This is a request only. We will confirm actual time & date of appointment via email.**

REGULAR HOURS:
Monday-Friday: 7:30AM-5:30PM

First Choice: (Required)

Date

Time:

Second Choice: (Optional)

Date

Time:

Third Choice: (Optional

Date

Time:

THIS IS A REQUEST ONLY. We will confirm actual time & date of appointment via email. If you don't receive an email
within 24 hours to confirm appointment, please call us at 515-232-8809.