GBIS Insulation Form - Eco Systems Group | Your Energy Saving Partner

Great British Insulation Scheme:

Confirm what Insulation measures you would like to install:

Have you had any changes to your property since your last EPC? If yes, please tick any of the following:

If you selected "Insluation Upgrades" please list them below:

Do you receive any of the qualifying benefits? Please tick all that apply:

Pension Credit Guarantee Credit Pension Credit Saving Credit Income-related Employment and Support Allowance (ESA) Income-based Jobseeker’s Allowance (JSA) Income Support Housing Benefit Tax Credits (Child Tax Credits and Working Tax Credits) Universal Credit Warm Home Discount payment

What are your main heating systems?

Gas Electric

What type of windows do you have?

UPVC Aluminium Wood Critel

Do your windows have trickle Vents installed?

Yes No

Do you have working Extractor Fans in your kitchen and bathroom?

Yes No

Property Information:

Do you know what year the property was built? If so, please state:

Does your Property have a pitch roof, flat roof, or both?

Pitch Flat Both

Do you have any other extensions? If so, please state:

Are you currently undergoing any renovations on your property?

Yes No

What is your wall construction type?

Cavity Solid Don't Know

Do you have drill patterns on your wall?

Yes No

Do you have any vents on your external walls?

Yes No

Do you have any tile hang sections?

Yes No

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The Great British Insulation Scheme

Insulation Form

Great British Insulation Scheme:

Property Information: