Free Home Survey –Home Insulation Survey UK.

Title :

Mr Mrs Ms

First Name :

Surname :

Address 1 :

Address 2 :

Address 3 :

Town :

County :

Postcode :

Daytime Telephone :

Evening Telephone :

Email Address :

Are you in receipt of any
Benefits, Allowances or
Credits?

Yes No

If yes which one?

* not including single occupancy discount
** earning less than £14,600 per annum

About the property:

Do you own the property?

Yes No

Have you had a previous grant in the last 10 years for the same work?

Yes No

Have you had a visit from a surveyor for the work?

Yes No

About the loft: (Only complete if interested in loft insulation)

Was the property built in 2000 or later?

Yes No

Does the loft have a hatch for access?

Yes No

Is there room for someone to work in the loft?

Yes No

Has the loft been converted?

Yes No Partly

Is the loft boarded?

Yes No Partly

Roughly when was the loft last insulated?

How deep is the present insulation?

Is the loft empty, or can it be emptied?

Yes No

Any other relevant information?

About the cavity: (Only complete if interested in cavity insulation)

Roughly how old is the property?

Does it have cavity walls?

Yes No

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