Estimate Request Estimate Request Phone Are there any specific areas in your home that are too warm or too cold (ex. Upstairs, Master Bedroom, etc.)? Are there any specific areas in your home that are too warm or too cold (ex. Upstairs, Master Bedroom, etc.)? Does your home get too muggy in the summer or too dry in the winter? Does your home get too muggy in the summer or too dry in the winter? Yes No Is there a family member that suffers from asthma or has problems with allergies? Is there a family member that suffers from asthma or has problems with allergies? Yes No Are you pleased with the current system controls or thermostat? Are you pleased with the current system controls or thermostat? Yes No Are you interested in smart phone or Internet access for your heating and cooling system? Are you interested in smart phone or Internet access for your heating and cooling system? Yes No Is the current indoor unit and/or ductwork noisy? Is the current indoor unit and/or ductwork noisy? Yes No Is the current outdoor unit noisy or in an undesirable location? Is the current outdoor unit noisy or in an undesirable location? Yes No Have there been any recent repairs done on the system? Have there been any recent repairs done on the system? Yes No If yes, please explain: If yes, please explain: Do you have any concerns about the current system’s reliability or warranty? Do you have any concerns about the current system’s reliability or warranty? Yes No Are you concerned about energy costs? Are you concerned about energy costs? Yes No Do you have a budget in mind for system or component replacement? Do you have a budget in mind for system or component replacement? Yes No Do you have any coupons / special promotions / incentives? Do you have any coupons / special promotions / incentives? Yes No Name * Address Address 2 City State North Carolina South Carolina Zip Phone Number * Email Address * Referred By: Type of Estimate Cool Only Heat Only Heat / Cool Water Heater Other (Explain below) Explain Other: Age of Current System Approximate Square Footage of Home Comments:
