"*" indicates required fields

Date of survey

DD slash MM slash YYYY

Customer Name*

Address*

About the house

Roughly when was the house built?*

What is the external wall construction and thickness*

Window Type (single, double, plastic , wood etc)*

Is there a hot water cylinder installed*

Is the roof insulated? How thick*

Is the ground floor wooden, concrete etc*

Is the house currently warm*

Annual heating bill*

How old is the current boiler*

Current fuel used for heating*

Details required for quick heat loss calculation

Average length of ground floor*

Average width of ground floor*

Average length of 1st floor*

Average width of 1st floor*

Average length of 2nd floor*

Average width of 2nd floor*

Items to photograph (For MCS & your records)

The existing boiler showing the pipework connected*

Max. file size: 512 MB.

The boiler nameplate showing model no*

Max. file size: 512 MB.

The old hot water cylinder and cupboard*

Max. file size: 512 MB.

The pipework connecting to any one radiator*

Max. file size: 512 MB.

The fuse board showing fuses*

Max. file size: 512 MB.