• Contact Name

  *
• Business Name
• Email

  *
• Phone

  *
• Address
• City
• Province
• Postal Code
• a

  Select A Maxim Service Location Winnipeg South Side - 45 Lowson Cres - (204) 925-7080 Edmonton - 13240 170th St NW - (780) 448-3830

  *

Vehicle Being Serviced

• Make

  *
• Model

  *
• Year

  *
• Vin#
• Kilometers

Describe Service Needs

• What kind of service do you need done?

  *
• Appointment Date

  *

Prior Service History

• Have we serviced your vehicle before?

  Yes No