SCHEDULE A SERVICE APPOINTMENT


Please complete and submit this form, and an appointment setter will contact you shortly.
( fields marked with a "*" are required ) Privacy Policy
PERSONAL INFORMATION
First Name:*
 
Last Name:*
 
E-Mail:*
 
Phone:*
 
Phone 2:
VEHICLE INFORMATION
Make:*  
Model:  
Year:*  
Miles:
VIN (17 Characters):
License Plate:
APPOINTMENT INFORMATION
First Choice:*

Time:

Date:

Second Choice:*

Time:

Date:

Alternate Transportation:

Select a method of alternative transportation during your service. Hover your mouse cursor over each type to see a description.

  • Waiter
  • Shuttle
  • Loaner
  • Pick-Up/Delivery
  • Pick-Up and Delivery with Loaner
Select One:

Please describe problem/reason for service:
ADDITIONAL COMMENTS or QUESTIONS
PLEASE CALL TOLL FREE 1-888-307-4589 or 281-554-9100 • Gulf Freeway (I-45 South) Exit 22, Brittany Bay Blvd and U-turn
ALEX RODRIGUEZ MERCEDES-BENZ © 2005, 2006, 2007