Please Note: A service representative will contact you to confirm your appointment. This form is for informational purposes only and does not automatically set an appointment.

Contact Information
Your First & Last Name •		Email Address •
Phone Number
Vehicle Information
VIN •	Vehicle Year / Make / Model
Engine	Transmission	Odometer
Service Type
Type of service Oil Change Lube, Oil and Filter Tune Up Other	Brakes New Tires Tire Rotation	Automatic Transmission Fluid Change Cooling System Flush Scheduled Maintenance (Fill in mileage above)
Request Appointment Date and Time
Day • Monday Tuesday Wednesday Thursday Friday Saturday	Date / Month • January February March April May June July August September October November December	Time • AM PM
Request Secondary Appointment Date and Time
Day Monday Tuesday Wednesday Thursday Friday Saturday	Date / Month January February March April May June July August September October November December	Time AM PM
Other Information
Are you a previous customer?
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Do you need a Dodge, Chrysler or Jeep Serviced in the Longview-Tyler, East Texas area? Peters Chevrolet has factory trained & certified technicians that can diagnose and repair any Dodge, Chrysler, Jeep ; car, truck, suv or van. Just use the handy Service Form above to schedule your next visit.