Lemon Law Assist Website Intake

1

What car problem are you having?

Transmission

Engine

Electrical

Other Issue

2

How many times have you taken your car to the dealership for repair?* This field is required.

3+

2

1

0

4

What's the Make and Model of your car?* This field is required.For example, Chevy Silverado

5

In what state did you get your car from?* This field is required.

6

What's your name?* This field is required.

First Name

Last Name

7

What's your email?* This field is required.

example@example.com

8

9

What's the best phone number to reach you directly?* This field is required.By submitting this form, you consent to Lemon Law Assist's Privacy Policy and agree we and our third-party affiliates can contact you by phone, text, or email, even if your number is on a do-not-call list. You're not required to purchase anything.

Area Code

Phone Number