(* indicates required field)
Please take advantage of our 'e-appointment' by filling out as much information as possible. We will contact you by e-mail or phone to confirm the reservation. Please request by our on-line form at least 72 hours in advance. If you need more immediate assistance, call us directly at 1 800-791-4308 to request your appointment.
Vehicle Information   Contact Information
*Year:
*Make:
*Model:
Mileage:
License Plate #:
 		  
*First Name:
*Last Name:
*Home Phone:
*Daytime Phone:
*E-mail:
Fax:
Preferred Contact Method:
Address:
City:
State:
Zip:
   
Additional Questions or Comments:

Service Information
Type of service needed:

Do you Require:
Shuttle Service
Rental Car
Wait in Lounge

*Preferred Appointment Time:

Alternate Appointment Time:

 
     

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808-873-8084
info@islandhonda.com
110 S. Hana Hwy.
Kahului, Maui, Hawaii, 96732

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