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YOUR CART
Appointment Request Form
If possible, I'll repair your bike on the spot when I arrive!
However, larger repairs and repairs involving replacement parts may require me to hold onto your bike for a bit.
Please click the button below for info on my pickup/drop-off rates.
Pickup & Drop-Off Pricing
*
Indicates required field
How would you prefer to arrange the hand-off?
*
I need you to pick my bike up.
I'd prefer to have my bike serviced at my home*
Personal Contact Info:
Name
*
First
Last
Email
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Phone Number
*
I prefer
*
Texts
Calls
Either
Information about your bike:
Do you have multiple bikes that need servicing?
*
No
Yes
If yes, please either: Submit two repair request forms OR include a brief description of additional bicycles in the "Additional Details" field below.
Bicycle Year
*
Pre 1970's
1970-1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
If you don't know the exact year, give me your best guess. This information helps me determine parts compatibility and cost estimates.
Bicycle Manufacturer
*
Bicycle Model
*
This information helps me determine parts compatibility and cost estimates.
Bicycle Type
*
Please Select
Hybrid
Cruiser
MTB - Rigid
MTB - Hardtail
MTB - Full Suspension
Road - Race/Endurance
Road - CX/Gravel/Adventure/Touring
Road - TT/Tri
Recumbent Bike
Recumbent Trike
Recumbent Quad
Folding
Tandem
Children's
Other
Is this bicycle motorized?
*
No
Yes - Electric Motor (Hub)
Yes - Electric Motor (Bottom Bracket)
Yes - Electric Motor (Chain/Belt Driven)
Yes - Gasoline (Also has pedals)
Yes - Gasoline (Throttle only; no pedaling)
I'd like to schedule a(n)...
*
Tune-Up
Once-Over
Tune-Up & Drivetrain Clean
A La Carte Repair
Select any and all issues that apply to your bike:
*
Braking
Shifting
Tire(s)/Tube(s)
Headset Bearings
Wheel Bearings
Bottom Bracket Bearings
Excessive noise while pedaling
Excessive noise while braking
Front Suspension
Rear Suspension
Unsure
None
Other (Please describe below)
Additional Details
*
Please include a short summary of your concerns about and desires for your bike.
Submit