Request edit access
Abundant Life Auto Clinic
Sign Up Form

This auto clinic serves families who are in relationship with Abundant Life or Abundant Life's partner organizations. We understand that car care can be difficult and expensive. In an effort to serve and support local families, we host the auto clinic monthly on the second Saturday from 8:00AM - 4:30PM in Arlington. All services provided at the auto clinic are free.

At the clinic, we provide basic car services including oil/filter changes, brake inspections and vehicle inspections. We ask that you take the time to completely fill out this form.

Any entries made after the Wednesday prior to clinic will be given priority for the following clinic. In an effort to service all of our guests well, we ask that you promptly inform us of any changes or cancellations of your appointment at least 48 hours in advance. By doing this, we will be able to fill cancellations with other families in need of car services.
Sign in to Google to save your progress. Learn more
Email *
Which of Our Partner Organizations Referred You to the Auto Clinic? *
First Name *
Last Name *
Phone Number *
Vehicle Make *
Vehicle Model *
Vehicle Year *
License Plate Number? *
We use this to look up the appropriate parts (oil, brakes and brake pads). If you would prefer, you can send us the VIN # for your vehicle.
Are you the registered owner of the vehicle? *
Is you vehicle safe to drive to the Auto Clinic? *
Describe why using the Auto Clinic fills a need for you. *
What service do you need? *
Please select all that apply
If you need a brake job, please specify which set.
Clear selection
Have you attended the Auto Clinic before? *
If there are any additional services requested, please tell us about them here. We cannot guarantee provision of these additional services.
The Auto Clinic is located in a comfortable events barn with a large playground. Children are welcome to attend!
How many children will be attending this auto clinic with you? *
If children are attending, what are their ages?
Do you have a service animal that will be attending the event with you? Service animals will not be permitted indoors. *
Does your vehicle utilize a Blow-And-Go device? If yes, please bring at least 1 unused mouth piece for our mechanics. *
The Auto Clinic is open from 8:00am - 4:30pm. Time requests will be given consideration, although they cannot be guaranteed. If you have a time preference please add it below. Availability is limited.
Time
:
Thank You!
Thank you for completing this sign up form! Our team will contact you soon with directions and day of information for the Auto Clinic.
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy