AUTO · CONTACT FORM TEMPLATE

Auto Repair Quote & Appointment Form

Auto repair quotes need year/make/model and a clear symptom — without those, the service writer is guessing. The form is the same intake your phone CSR runs, just self-serve.

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1,000/mo free·no card·works on any host

form.htmlhtml41 lines

01<form action="https://splitforms.com/api/submit" method="POST">
02  <input type="hidden" name="access_key" value="YOUR_ACCESS_KEY">
03  <input type="hidden" name="subject" value="New auto repair request">
04 
05  <label for="name">Full name *</label>
06  <input id="name" type="text" name="name" placeholder="Daniel Chen" required>
07  <label for="email">Email *</label>
08  <input id="email" type="email" name="email" placeholder="daniel@example.com" required>
09  <label for="phone">Phone *</label>
10  <input id="phone" type="tel" name="phone" placeholder="+1 555 0142" required>
11  <label for="vehicle">Year / make / model *</label>
12  <input id="vehicle" type="text" name="vehicle" placeholder="2019 Toyota RAV4" required>
13  <label for="mileage">Mileage</label>
14  <input id="mileage" type="number" name="mileage" placeholder="65000">
15  <label for="service">Service needed *</label>
16  <select id="service" name="service" required>
17    <option value="">Choose…</option>
18    <option>Oil change</option>
19    <option>Brake service</option>
20    <option>Tire / alignment</option>
21    <option>Check engine light</option>
22    <option>Battery / electrical</option>
23    <option>AC service</option>
24    <option>Major repair / diagnosis</option>
25    <option>Pre-purchase inspection</option>
26    <option>Other</option>
27  </select>
28  <label for="symptoms">What's the car doing? *</label>
29  <textarea id="symptoms" name="symptoms" placeholder="Noises, warning lights, when it happens…" required></textarea>
30  <label for="drop_off">Preferred drop-off date</label>
31  <input id="drop_off" type="date" name="drop_off">
32 
33  <!-- honeypot — bots fill every field -->
34  <input type="checkbox" name="botcheck" style="display:none" tabindex="-1" autocomplete="off">
35 
36  <button type="submit">Send</button>
37</form>
38 
39<p style="margin-top:12px;font-size:11px;color:#888;text-align:right">
40  Powered by <a href="https://splitforms.com" style="color:#888;text-decoration:none" target="_blank" rel="noopener">splitforms</a>
41</p>

1,000

submissions / mo, free

fields, ready to ship

code outputs

60s

from copy to inbox

Auto Repair Quote & Appointment Form — example splitforms template with submissions inbox

§ 01Why it mattersthe qualifying-fields argument

The phone-call intake at every shop runs the same script: year, make, model, mileage, symptom. The form just lets the customer fill that in at midnight when they realise the brakes are squealing. Service writers can prep the bay, pull the right parts catalog, and quote within an hour of arrival. The customer who fills out a form before bed beats the customer who calls at 8am — they're at the head of the queue.

✦ at a glance

→Auto repair / mechanic quote · 8 fields
→HTML, JS, React, PHP, cURL outputs
→One POST endpoint, no SDK
→Honeypot + classifier, no CAPTCHA

§ 02Live previewinteractive · sandboxed · no key required

See exactly what your visitors see — and you’ll receive.

Left: the rendered form, fully interactive in a sandboxed iframe. Right: the email and dashboard view that lands the moment a visitor submits.

preview · auto-repair-contact-formlocalhost:3000

✦ what you’ll see in your inbox

Every submission becomes an email plus a dashboard row. The fields below are the exact payload your form will send. Reply-to is wired to the visitor’s email so hitting reply goes back to them.

dashboard · new submission14ms · 200 OK

SUBJECT · New auto repair request

Full name: Maya Iyer
Email: maya@studio71.co
Phone: +1 415 555 0142
Year / make / model: —
Mileage: —
Service needed: Oil change
What's the car doing?: —
Preferred drop-off date: 2026-05-15

Iframe is sandboxed — submit doesn’t actually fire. Get your access key to wire it up live.

§ 03Three steps3 steps · ~60 seconds

Generate, embed, receive.

Three actions stand between you and your first lead. None of them require a backend, a database, or a CAPTCHA library.

STEP 01GENERATE

Capture vehicle and symptom

Required: year, make, model, mileage, symptom or service requested. Optional: VIN (autofills service history if integrated with CARFAX / Mitchell).

Create your form

key=sk_live_••••••••

STEP 02EMBED

Suggest appointment slots

Form's last field is preferred date/time window. Webhook into your shop management software (Mitchell1, Tekmetric, Shop-Ware) and confirm the slot via SMS.

snippethtml

<form action="https://splitforms.com/api/submit" method="POST">
  …
</form>

STEP 03RECEIVE

Quote on common services

For oil changes, brakes, batteries — quote the menu price client-side. For diagnostic and transmission — book the diagnostic, quote after.

inbox · 1 newjust now

FROM contact@yoursite.com

New auto repair request

Maya Iyer maya@studio71.co

Loved your last open house in Hayes — looking for similar with parking. Pre-approved through Wells Fargo.

§ 04Copy & ship5 languages · same endpoint

Five outputs. One backend.

HTML by default. Click open the language you ship in — every variant POSTs to the same /api/submit endpoint.

01HTMLform.html41 lines

<form action="https://splitforms.com/api/submit" method="POST">
  <input type="hidden" name="access_key" value="YOUR_ACCESS_KEY">
  <input type="hidden" name="subject" value="New auto repair request">

  <label for="name">Full name *</label>
  <input id="name" type="text" name="name" placeholder="Daniel Chen" required>
  <label for="email">Email *</label>
  <input id="email" type="email" name="email" placeholder="daniel@example.com" required>
  <label for="phone">Phone *</label>
  <input id="phone" type="tel" name="phone" placeholder="+1 555 0142" required>
  <label for="vehicle">Year / make / model *</label>
  <input id="vehicle" type="text" name="vehicle" placeholder="2019 Toyota RAV4" required>
  <label for="mileage">Mileage</label>
  <input id="mileage" type="number" name="mileage" placeholder="65000">
  <label for="service">Service needed *</label>
  <select id="service" name="service" required>
    <option value="">Choose…</option>
    <option>Oil change</option>
    <option>Brake service</option>
    <option>Tire / alignment</option>
    <option>Check engine light</option>
    <option>Battery / electrical</option>
    <option>AC service</option>
    <option>Major repair / diagnosis</option>
    <option>Pre-purchase inspection</option>
    <option>Other</option>
  </select>
  <label for="symptoms">What's the car doing? *</label>
  <textarea id="symptoms" name="symptoms" placeholder="Noises, warning lights, when it happens…" required></textarea>
  <label for="drop_off">Preferred drop-off date</label>
  <input id="drop_off" type="date" name="drop_off">

  <!-- honeypot — bots fill every field -->
  <input type="checkbox" name="botcheck" style="display:none" tabindex="-1" autocomplete="off">

  <button type="submit">Send</button>
</form>

<p style="margin-top:12px;font-size:11px;color:#888;text-align:right">
  Powered by <a href="https://splitforms.com" style="color:#888;text-decoration:none" target="_blank" rel="noopener">splitforms</a>
</p>

02JavaScriptform.js57 lines

<form id="lf-form">
  <label for="name">Full name *</label>
  <input id="name" type="text" name="name" placeholder="Daniel Chen" required>
  <label for="email">Email *</label>
  <input id="email" type="email" name="email" placeholder="daniel@example.com" required>
  <label for="phone">Phone *</label>
  <input id="phone" type="tel" name="phone" placeholder="+1 555 0142" required>
  <label for="vehicle">Year / make / model *</label>
  <input id="vehicle" type="text" name="vehicle" placeholder="2019 Toyota RAV4" required>
  <label for="mileage">Mileage</label>
  <input id="mileage" type="number" name="mileage" placeholder="65000">
  <label for="service">Service needed *</label>
  <select id="service" name="service" required>
    <option value="">Choose…</option>
    <option>Oil change</option>
    <option>Brake service</option>
    <option>Tire / alignment</option>
    <option>Check engine light</option>
    <option>Battery / electrical</option>
    <option>AC service</option>
    <option>Major repair / diagnosis</option>
    <option>Pre-purchase inspection</option>
    <option>Other</option>
  </select>
  <label for="symptoms">What's the car doing? *</label>
  <textarea id="symptoms" name="symptoms" placeholder="Noises, warning lights, when it happens…" required></textarea>
  <label for="drop_off">Preferred drop-off date</label>
  <input id="drop_off" type="date" name="drop_off">
  <button type="submit">Send</button>
</form>

<p style="margin-top:12px;font-size:11px;color:#888;text-align:right">
  Powered by <a href="https://splitforms.com" style="color:#888;text-decoration:none" target="_blank" rel="noopener">splitforms</a>
</p>

<script>
  document.getElementById('lf-form').addEventListener('submit', async (e) => {
    e.preventDefault();
    const data = new FormData(e.target);
    data.set('access_key', 'YOUR_ACCESS_KEY');
    data.set('subject', 'New auto repair request');

    const res = await fetch('https://splitforms.com/api/submit', {
      method: 'POST',
      body: data,
      headers: { Accept: 'application/json' },
    });

    const json = await res.json();
    if (json.success) {
      e.target.reset();
      alert('Sent!');
    } else {
      alert('Error: ' + (json.message || 'Try again'));
    }
  });
</script>

03React / Next.jsForm.tsx72 lines

'use client';

import { useState, type FormEvent } from 'react';

export default function AutoRepairQuoteForm() {
  const [status, setStatus] = useState<'idle' | 'sending' | 'sent' | 'error'>('idle');

  async function onSubmit(e: FormEvent<HTMLFormElement>) {
    e.preventDefault();
    setStatus('sending');

    const data = new FormData(e.currentTarget);
    data.set('access_key', 'YOUR_ACCESS_KEY');
    data.set('subject', 'New auto repair request');

    const res = await fetch('https://splitforms.com/api/submit', {
      method: 'POST',
      body: data,
      headers: { Accept: 'application/json' },
    });

    const json = await res.json();
    setStatus(json.success ? 'sent' : 'error');
    if (json.success) e.currentTarget.reset();
  }

  if (status === 'sent') return <p>Thanks — we&rsquo;ll be in touch.</p>;

  return (
    <>
    <form onSubmit={onSubmit}>
      <label htmlFor="name">Full name *</label>
      <input id="name" type="text" name="name" placeholder="Daniel Chen" required />
      <label htmlFor="email">Email *</label>
      <input id="email" type="email" name="email" placeholder="daniel@example.com" required />
      <label htmlFor="phone">Phone *</label>
      <input id="phone" type="tel" name="phone" placeholder="+1 555 0142" required />
      <label htmlFor="vehicle">Year / make / model *</label>
      <input id="vehicle" type="text" name="vehicle" placeholder="2019 Toyota RAV4" required />
      <label htmlFor="mileage">Mileage</label>
      <input id="mileage" type="number" name="mileage" placeholder="65000" />
      <label htmlFor="service">Service needed *</label>
      <select id="service" name="service" required>
        <option value="">Choose…</option>
        <option>Oil change</option>
        <option>Brake service</option>
        <option>Tire / alignment</option>
        <option>Check engine light</option>
        <option>Battery / electrical</option>
        <option>AC service</option>
        <option>Major repair / diagnosis</option>
        <option>Pre-purchase inspection</option>
        <option>Other</option>
      </select>
      <label htmlFor="symptoms">What's the car doing? *</label>
      <textarea id="symptoms" name="symptoms" placeholder="Noises, warning lights, when it happens…" required />
      <label htmlFor="drop_off">Preferred drop-off date</label>
      <input id="drop_off" type="date" name="drop_off" />

      <button type="submit" disabled={status === 'sending'}>
        {status === 'sending' ? 'Sending…' : 'Send'}
      </button>

      {status === 'error' && <p>Something went wrong. Try again.</p>}
    </form>

      <p style={{ marginTop: 12, fontSize: 11, color: '#888', textAlign: 'right' }}>
        Powered by <a href="https://splitforms.com" target="_blank" rel="noopener" style={{ color: '#888', textDecoration: 'none' }}>splitforms</a>
      </p>
    </>
  );
}

04PHPsubmit.php28 lines

<?php
// Drop into a PHP page. Receives a form POST and proxies it to splitforms.com.
// Useful when you want to add server-side validation or rate limiting.

if ($_SERVER['REQUEST_METHOD'] === 'POST') {
    $allowed = ['name', 'email', 'phone', 'vehicle', 'mileage', 'service', 'symptoms', 'drop_off'];
    $payload = ['access_key' => 'YOUR_ACCESS_KEY'];
    $payload['subject'] = 'New auto repair request';

    foreach ($allowed as $f) {
        if (isset($_POST[$f])) $payload[$f] = $_POST[$f];
    }

    $ch = curl_init('https://splitforms.com/api/submit');
    curl_setopt($ch, CURLOPT_POST, true);
    curl_setopt($ch, CURLOPT_POSTFIELDS, http_build_query($payload));
    curl_setopt($ch, CURLOPT_RETURNTRANSFER, true);
    curl_setopt($ch, CURLOPT_HTTPHEADER, ['Accept: application/json']);
    $response = curl_exec($ch);
    $status   = curl_getinfo($ch, CURLINFO_HTTP_CODE);
    curl_close($ch);

    header('Content-Type: application/json');
    http_response_code($status);
    echo $response;
    exit;
}
?>

05cURLtest.sh12 lines

curl -X POST https://splitforms.com/api/submit \
  -H "Accept: application/json" \
  -d "access_key=YOUR_ACCESS_KEY" \
  -d "subject=New auto repair request" \
  -d "name=Jane Builder" \
  -d "email=jane@example.com" \
  -d "phone=+15555555555" \
  -d "vehicle=Jane Builder" \
  -d "mileage=1" \
  -d "service=Oil change" \
  -d "symptoms=Hello from cURL" \
  -d "drop_off=2026-05-15"

Replace YOUR_ACCESS_KEY with the key from your dashboard. That’s the only edit.

§ 04bUse this template with…17 frameworks · same backend

One template. Every framework.

The same field set works on every framework splitforms supports. HTML, React, Next.js, Vue, Astro, Hugo, WordPress — same POST, same backend.

§ 06FAQ4 answered

Things people ask before they ship.

Direct answers, no marketing fluff. Missing one? Email hello@splitforms.com.

01Should I quote brake jobs from the form?

Front pads: yes, menu price. Pads + rotors + calipers: no, you need to inspect first. Most shops quote a 'starting at' price for pads and a free brake inspection. The form schedules the inspection.

02Can I integrate with Mitchell1 / Tekmetric / Shop-Ware?

Yes — webhook the JSON. All major shop management platforms accept inbound webhooks via Zapier. VIN, vehicle, and symptom land in your system before the customer arrives.

03What about CARFAX or service-history pulls?

If you have a CARFAX dealer subscription, the VIN field on the form triggers a webhook that pulls history before the customer arrives. Service writer prepped, conversation goes faster.

04Do customers actually fill these out?

After-hours, yes — especially for larger jobs (transmission, engine, suspension). Routine stuff (oil, tires) tends to come in by phone or walk-in. Both channels matter; the form catches the after-hours diagnosis tickets.

✻ ✻ ✻

Ship your auto repair quote & appointment form in 60 seconds.

1,000 free submissions per month. No credit card. Copy the snippet, paste your access key, watch leads land in your inbox.

Get free access key →Browse all 60 templates →

v0.1 · founders pricing locked in · early access open