Energy Smart Initial Consultation Form
Please fill out completely, it helps both of us understand what you would like to fix. There is a $25 additional charge if questions are left blank.
Name
Your answer
Street Address
Your answer
City
Your answer
State
Your answer
Zip Code
Your answer
Best Phone Number to Reach You
Cell phones are usually best
Your answer
Alternate Phone
If you're tough to catch, help us out. =)
Your answer
Email Address
Your answer
About how many pages did you read on the web site?
How many square feet is your home?
A ballpark is fine.
Your answer
What year was it built?
Again, a ballpark is fine - 1920? 1950? 2000?
Your answer
How long have you owned the home?
Your answer
How long do you plan to stay in your home?
Your answer
How many people live there?
Your answer
How did you hear about us?
Check as many as apply.
How do you think we can help?
What problem(s) are you looking to solve?
Your answer
Have you ever had work performed at your home you were really disappointed with?
Your answer
Do you notice any Indoor Air Quality problems?
Moisture in basement or attic, dusty areas, indoor allergies, asthma, areas where odors linger. (No judgement here! 90% of homes have at least 1 IAQ problem, we can test for them, too!)
Your answer
What improvements have you made since you bought the home? If you remember an approximate year, please note that.
New roof? Furnace or AC? Kitchen or bath remodel? Addition? Insulation? Anything else?
Your answer
Do you have at least 1 year's worth of gas and electric bills (or other fuel) you could provide us with?
These help us determine how much opportunity you have - is your house a Hummer or a Prius? Online you can get 3 years of Dominion bills and 1 year of First Energy/Ohio Edison. If you've recently moved, we know a few tricks.
Your answer
What prompted you to reach out?
Yep, this is a bit of a repeat, we find clients come up with better answers when we ask them a little differently. The more we understand about what you want to solve, the more likely we can solve it. Neglect to tell the doctor your knee hurts, in addition to the elbow hurting you went to him for, and don't be surprised if your knee doesn't get fixed. It's partly the doctor's fault for not asking the question, so we try to ask a lot of questions.
Your answer
Have you ever had an energy audit? Have you had one at this home? From whom, if you have?
Your answer
What problems have you had in the past with your home?
Wet basement, needed pest control, ice dams, mold, etc.
Your answer
What problems are you looking to solve right now?
These may or may not relate to what you called Energy Smart for, but may affect our recommendations.
Your answer
What are the top 3 problems with your home you would like Energy Smart to solve for you?
Have your answers changed slightly? =)
Your answer
Which type of initial consultation would you like?
Daytime, Evening, or Weekend. Cleveland and Akron Ohio areas for local consult. It is very important all decision makers are there so we can get a complete picture. Typically this means both spouses, but there are lots of family types these days! =)
Date 1: Please provide 2 dates and times 2-3 weeks out that would be convenient for both you and your significant other for an initial consultation during the week.
Please pick a date 2-3 weeks out. It's VERY important both of you are there - this is a collaborative process and all input is needed to develop a true solution.
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Time
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Date 2: A second date/time that works for both you and your significant other.
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Time
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That's too tricky!
What day(s) usually work best and when?
Your answer
OPTIONAL - Any suggestions for improving this form?
Your feedback is valued. It's how we improve. Thank you!
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