Need a quote?Complete our questionnaire below...Please enable JavaScript in your browser to complete this form.Lead Generator Details - Step 1 of 11Lead Generator name *Lead Generator reference Lead Generator email *NextCustomer name *Customer address *Postcode *Customer telephone *Customer email *Customer date of birthDD12345678910111213141516171819202122232425262728293031/MM123456789101112/YYYY202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Customer tenureHomeownerPrivate rentedSocial rentedOtherPreviousNextWhat is the local authority area? *Aberdeen City CouncilAberdeenshire CouncilAngus CouncilArgyll and Bute CouncilCity of Edinburgh CouncilClackmannanshire CouncilComhairle nan Eilean SiarDumfries and Galloway CouncilDundee City CouncilEast Ayrshire CouncilEast Dunbartonshire CouncilEast Lothian CouncilEast Renfrewshire CouncilFalkirk CouncilFife CouncilGlasgow City CouncilInverclyde CouncilMidlothian CouncilNorth Ayrshire CouncilNorth Lanarkshire CouncilOrkney Islands CouncilPerth and Kinross CouncilRenfrewshire CouncilScottish Borders CouncilShetland Islands CouncilSouth Ayrshire CouncilSouth Lanarkshire CouncilStirling CouncilThe Highland CouncilThe Moray CouncilWest Dunbartonshire CouncilWest Lothian CouncilWhat is the local authority area? *Aberdeen City CouncilAberdeenshire CouncilAngus CouncilArgyll and Bute CouncilCity of Edinburgh CouncilClackmannanshire CouncilComhairle nan Eilean SiarDumfries and Galloway CouncilDundee City CouncilEast Ayrshire CouncilEast Dunbartonshire CouncilEast Lothian CouncilEast Renfrewshire CouncilFalkirk CouncilFife CouncilGlasgow City CouncilInverclyde CouncilMidlothian CouncilNorth Ayrshire CouncilNorth Lanarkshire CouncilOrkney Islands CouncilPerth and Kinross CouncilRenfrewshire CouncilScottish Borders CouncilShetland Islands CouncilSouth Ayrshire CouncilSouth Lanarkshire CouncilStirling CouncilThe Highland CouncilThe Moray CouncilWest Dunbartonshire CouncilWest Lothian CouncilPreviousNextWhat measure is the customer interested in? Click all that apply. *Replacement gas boilerUnder-floor insulationCavity wall insulationLoft insulationRoom in roof insulationInternal wall insulationExternal wall insulationFirst time central heatingElectric storage heatersSmart thermostatOtherPreviousNextWhat state benefit does the customer receive? Click all that apply. *Armed forced independent paymentAttendance allowanceCarer's allowanceChild BenefitChild Tax CreditsConstant attendance allowanceDisability living allowancePension Credit Guarantee ElementPersonal independence paymentIncome-related employment & support allowance (ESA)Income-related jobseeker's allowance (JSA)Income supportIndustrial injuries disablement benefitSevere disablement allowanceUniversal CreditWar pensions mobility supplementWorking Tax CreditsUnknown / No benefitsLocal Authority FlexibilityPreviousNextWhat is the house type?BungalowHouseFlatMaisonettePark HomePreviousNextWhat is the house detachment?DetachedSemi-detachedEnd-terracedMid-terracedPark HomePreviousNextHow many bedrooms are there?1 Bedroom2 Bedrooms3 Bedrooms4 Bedrooms5 Bedrooms6+ BedroomsPreviousNextWhat is the current heating type? *Gas boilerGas back boiler to room heatersGas fire with back boilerElectric storage heatersElectric room heatersElectric - boilerGas room heatersLPG boilerLPG bottled boilerLPG bottled room heatersOil boilerSolid fossil fuel boilerSolid fossil fuel room heatersOtherPreviousNextWhat is the wall construction type? Solid wall (brick or stone)Cavity wallTimber framed wallSystem build wallDon’t knowIf the wall is cavity, has it been insulated?Not applicable - not cavity wallYes - filled cavityNo - empty cavityDon’t knowCan you access underfloor to insulate?YesNoDon’t knowIs the boiler 7 years or older?Yes - 7 years or olderNo - less than 7 yearsDon’t knowNextIs a quotation required if ECO funding is not available?YesNoDon’t knowPlease write any other important information here By pressing submit you agree to our Privacy Policy *I agree with the Privacy PolicySubmit
