University Acura

Appointment Request Form

Use this form to request a service appointment.

Vehicle Information

*Manufacturer:
*Year:
*Model:
Miles:
VIN Number:

Service Information

*Type of Service Needed:

*Preferred Appointment Time:

*Alternate Appointment Time:

Contact Information

*Name:

*Email:

*Home Phone:

*Day Phone:

Fax:

Preferred Contact:

*Address:

City:

State:

Zip:

*These fields are required


900 West Shaw Avenue Clovis, CA 93612	Tel: (559) 294-6000 Fax: (559) 297-7307 Email: universityacura@tsan.com