Home Energy Upgrade Intake Form

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Learn how you can increase your home’s comfort and health, and decrease your utility bills at the same time by answering a few simple questions about energy use in your home.


Enter your email to create a new home assessment.

Next

Contact

  • 5 digits
Next Building

Building

Please fill out these questions to the best of your ability. All questions are optional, so if you don't know something, you don't have to enter anything.


  • 4 digits Tip
  • sq. feet Tip
  • Tip
  • Tip
  • Tip
  • Tip
    • Tip
    • Tip
    • Tip
    • Tip
    • Tip
    • Tip
    • Tip
Next Heating & Cooling

Heating Equipment

  • Tip
  • Tip
  • Tip
  • Tip
  • Tip
  • Tip

    Cooling Equipment

  • Tip
  • Tip
  • Tip
  • Tip
  • Tip
  • Tip
  • Tip
Next Appliances & Lighting

Refrigerators

  • Tip
  • Tip

Appliances

  • Tip
  • Tip
  • Tip
  • Tip
Next Utilities!

Utilities

  • $ Tip
  • $ Tip
  • $ Tip
  • $ Tip
  • Gallons Tip
  • - OR -
  • $
Next Problem Areas

Problem Areas

Health Issues

Concerns

Next General

General