Noise Symptom Checklist Template
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1NOISE SYMPTOM SHEET
Check All That Apply
AREA OF NOISE
Engine Compartment
Left
Right
Center
Don’t Know
Front Suspension
Left
Right
Center
Don’t Know
Rear Suspension
Left
Right
Center
Don’t Know
Passenger Compartment
Left
Right
Center
Don’t Know
Instrument Panel
Left
Right
Center
Don’t Know
Front Doors
Left
Right
Don’t Know
Rear Doors
Left
Right
Don’t Know
Front Seat Area
Left
Right
Center
Don’t Know
Rear Seat Area
Left
Right
Center
Don’t Know
Trunk
Left
Right
Center
Don’t Know
Center Console
Other:_________________________________________________________________
NOISE SOUNDS LIKE:
Knocking Ticking
Scraping
Whining
Squeaking Rattling
Grinding
Thumping
Other:_________________________________________________________________
HOW OFTEN DOES IT OCCUR?
ContinuousOften
Intermittent
Just Started
WHEN DOES IT OCCUR?
All the timeHigh speeds
Low speeds
On turns
Hard throttle Light throttle
Decelerating
Idling
Hot days Cold days
Raining
Braking
Big bumps Little bumps
Smooth roads
When starting
Coasting
In reverse
Steady speeds
Other:_________________________________________________________________
EXPLAIN IN MORE DETAIL (if needed):______________________________________
________________________________________________________________________________
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Parent category: Life