apply for a free survey today Start the process by completing the online form below. Insulation Measures Walls & Roof Insulation Name * First Name Last Name Email * Address * Postcode * Contact Number * (###) ### #### Date of birth * This is needed to confirm eligibility if you are receiving benefits. I'm interested in * Loft Insulation Cavity Wall Insulation External Wall Insulation Internal Wall Insulation Do you know your current EPC rating? * Properties with an EPC rating of A to C are too efficient and will not qualify. D E F G Unknown What is your Council Tax Band? * The GBIS Scheme only applies to bands A to D. A B C D E to H What is your current housing situation? * Unfortunately Council Housing and Housing Association do not qualify. Home Owner Privately Renting What type of property do you live in? * Flat/Maisonnette Bungalow House Does your home have any extensions? * Yes No Is your electricity single or dual tarriff? * Single Dual Are you currently receiving any of the eligible benefits? * None Pension Guarantee Credit Pension Savings Credit Housing Benefit Universal Credit Income Support Income based Jobseekers Allowance Income related Employment & Support Allowance Tax Credits (Child or working tax credit) Child Benefit (annual income below threshold) Warm Home Discount (Core Group Only) Do you qualify under La Flex? * Route 1 - Total household income is below £31,000 Route 3 - NHS Referral / Health Conditions N/a Additional information you wish to provide Heating Measures Upgraded Heating Systems Name * First Name Last Name Email * Address * Postcode * Contact Number * (###) ### #### Date of birth * This is needed to confirm eligibility if you are receiving benefits. I'm interested in * Solar Panels Boiler upgrade First Time Central Heating Air Source Heat Pumps Do you know your current EPC rating? * Properties with an EPC rating of A to C are too efficient and will not qualify. D E F G Unknown What is your current housing situation? * Unfortunately Council Housing and Housing Association do not qualify. Home Owner Privately Renting What type of property do you live in? * Flat/Maisonnette Bungalow House Does your home have any extensions? * Yes No Has your home had a loft conversion and/or a fixed staircase to reach your loft? * Yes No How is your home currently heated? * Condensing-combi boilers do not qualify for boiler upgrades. Electric Boiler Electric Room Heaters Electric Storage Heaters Mains Gas Combi Boiler (Condensing) Mains Gas Combi Boiler (Non-condensing) Mains Gas Regular Boiler (Condensing) Mains Gas Regular Boiler (Non-condensing) Lpg Boiler Oil Boiler Fossil Fuel Boiler Other (please specify below) Do you have a water tank? (These are usually in an airing cupboard) * Yes No Does your property have a working gas meter prior to April 2022? * Yes No Is your electricity single or dual tarriff? * Single Dual Are you currently receiving any of the eligible benefits? * None Pension Guarantee Credit Pension Savings Credit Housing Benefit Universal Credit Income Support Income based Jobseekers Allowance Income related Employment & Support Allowance Tax Credits (Child or working tax credit) Child Benefit (annual income below threshold) Warm Home Discount (Core Group Only) Do you qualify under La Flex? * Route 1 - Total household income is below £31,000 Route 3 - NHS Referral / Health Conditions N/a Additional information you wish to provide
