Service Request


ON-LINE SERVICE REQUEST FOR STEVENSVILLE LOCATION

NOT AVAILABLE FOR CENTERVILLE LOCATION! PLEASE CALL: 410-758-2552 FOR APPOINTMENT

Welcome to the Western Tire & Auto “Non-Emergency” On-Line Service Request. Please fill out the form below. Our service manager will call you after we receive your request to confirm your appointment. Please note that your request is NOT confirmed until you receive a call back from us.




First Name
Last Name

Email
Phone
Best Time to Call	Mornings Afternoon


Preferred Service Day
Preferred Service Time

Service Needed
Check all that apply
	Alignment
	Brakes
	Electrical
	Oil Change
	Shocks/Struts
	State Inspection
	Tires
	Other


Vehicle Description

Year
Make
Model

Additional Comments

STEVENSVILLE: 1406 Main Street Stevensville, MD 21666 (410) 643-5572 stevensville@westerntireandauto.com

CENTREVILLE: 204 E. Water Street Centreville, MD 21617 (410) 758-2552 centreville@westerntireandauto.com