First Name

Surname

Email Address

Repeat Email Address

Phone Number

Property Address including Postcode

What type of boiler is in the property at the moment -- What type of boiler is in the property at the moment --CombiBoiler does Central Heating onlyNone

Where is the current boiler installed in the property

Where would you like your new boiler installing i.e Loft Kitchen etc

What kind of exhaust flue pipe does your current boiler have -- What kind of exhaust flue pipe does your current boiler have --Round FlueSquare FlueNone

Is your existing flue 2 mtr above ground level or below this? -- Is your existing flue 2 mtr above ground level or below this? --YesNoNot Sure

Type of property

How many bedrooms does your house have -- How many bedrooms does your house have --1-23-45+

How many bathrooms does the property have -- How many bathrooms does the property have --1-23+

Would you like New smart heating Controls -- Would you like New smart heating Controls --YesNoNot Sure

Is your property connected to mains gas -- Is your property connected to mains gas --YesNo

Please provide any additional information you feel may help us here