HVAC Diagnostic Fee Acknowledgment (Sign Before the Diagnosis)
A one-page form the customer signs before an HVAC diagnosis starts: the diagnostic fee, what it covers, whether it is credited toward a same-day repair, and that any repair is quoted and approved separately.
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What’s in this template
HVAC Diagnostic Fee Acknowledgment
Signed before the diagnosis begins. It records the fee the customer agreed to pay for the diagnosis.
1. Visit
- Company: Company Name
- Technician: Technician
- Customer: Customer
- Service address: Service Address
- Date: Date
- Job or work order no.: Job or Work Order No.
2. System and Problem
- System: System Being Diagnosed
- Problem reported: Problem Reported
3. Diagnostic Fee
- Diagnostic fee: $Diagnostic Fee ($)
- The fee covers: What the Fee Covers
- Credit toward repair: Credit Toward Repair
The diagnostic fee is due for the diagnosis whether or not the customer decides to have the repair done, except as the credit term above says otherwise.
4. Repairs Are Quoted Separately
After the diagnosis the technician will explain what was found and quote any repair. No repair work starts until the customer approves the quote. This form covers the diagnosis only and does not authorize repair work.
5. Sign-Off
The customer confirms the fee, what it covers and the credit term above were explained before the diagnosis started, and that they received a copy.
Technician signature line
Customer (received a copy) signature line
Diagnostic fee acknowledgment questions, answered
What is a diagnostic fee acknowledgment?
A short form the customer signs before the technician starts diagnosing. It states the fee, what the fee pays for, whether it is credited toward a repair, and that the repair itself is priced and approved separately. It turns the fee from a surprise on the invoice into something agreed at the door.
When should the customer sign it?
After the technician arrives and before any diagnostic work begins. If the fee was already given on the phone or in the booking text, the form puts the same number in writing next to a signature.
What should the form say about the fee being credited?
Whatever your shop actually does. Some shops credit the full fee when the customer approves the recommended repair the same day, and some credit part of it or none. This form has a line for the credit term so the customer reads the same rule you apply on the invoice.
Does the signed form authorize the repair?
No. It covers the diagnosis only. The form says the repair is quoted after the diagnosis and needs its own approval before work starts.
Does this form satisfy my state's rules on service fees?
No form can promise that. Rules on disclosing service call and diagnostic fees vary by state and sometimes by license type. Use this as a record of what you told the customer, and check with your state licensing agency or a local attorney for what your state requires.
Do I need an account to use this form?
No. Download the blank form and print it, or fill in the visit details online and download a PDF. Neither needs an account.
Related
Get the fee signed on the doorstep
In EosLog the customer signs on your phone, and the signed fee stays attached to the job so the invoice and the credit line match what was agreed.