Service Appointment Request

Vehicle Information

* Year: Miles:
* Make: VIN:
* Model:
Service Information
  Type Of Service(s) Needed:
 
Oil change Brake Inspection Cooling system
Fuel filter Air filter Shocks
Spark plugs Timing belt Tire rotation
Transmission Wheel alignment Air conditioner
  Other/Additional Information:
 
 
  Preferred appointment time:
 
  Alternate Appointment Time:
 

Contact Information

* First Name: * Last Name:
Email: Home Phone:
Day Phone: Fax:
Cell Phone: Preferred Contact:
* Address:
* City: * ZIP Code:
* These fields are required

Baron Honda
17 Medford Ave-Rt 112
Patchogue, NY 11772
Phone: (631) 475-8400
Email: Contact Us
Fax: (631) 475-3954
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