Sign up for a free Water Check
* Required
Contact details
First name
*
Your answer
Last name
*
Your answer
Email address
*
Your answer
Phone number
*
Your answer
Second phone number
Your answer
Address
*
Your answer
Suburb
*
Your answer
Postcode
*
Your answer
What is your main interest in the programme?
*
I have a general interest
I want to reduce my water bills
I have a specific problem regarding water use in my household
I want to be more sustainable
Availability
What days suit you best for a visit?
Select as many options as you like
Monday
Tuesday
Wednesday
Thursday
Friday
What part of the day suits you best for a visit?
Click as many options as you like
Morning
Early afternoon
Late afternoon
Any additional comments about your availability?
We are currently not able to offer after hours or weekend visits
Your answer
Would you like to be seen with priority due to a specific issue?
Yes
No
Clear selection
Water usage information
How much are you paying for your water per month on average?
Your answer
How many people are living in your house or on your property?
Your answer
What type of water pressure do you have?
Electric mains pressure
Electric low pressure
Gas
Gas califont
Unsure
Other:
Clear selection
What is your Watercare account number?
Your answer
Do you give us consent to view your water usage information?
Yes
No
Clear selection
How did you find out about the free Water Check?
Via EcoMatters Environment Trust
Via the Watercare website
Via the Water For Life website
Via Our Auckland
From a friend / word of mouth
Via one of Auckland’s Home Shows
Watercare advised me I should get a Water Check done, as my water usage is high
Other:
Clear selection
Submit
Never submit passwords through Google Forms.
This form was created inside of EcoMatters Environment Trust.
Report Abuse
Forms