Boiler Installation Form

What type of house do you have* This field is required.

Semi

Detached

bungalow

Terrace

Flat

How many bedrooms are there* This field is required.

MORE THAN 5

What is your boiler type* This field is required.

Combi

Regular

System

Back Boiler

Do you want to replace it with a Combination Boiler * This field is required.

YESNO

What room is your boiler in* This field is required.

Living room

Bedroom

Bathroom

Utiltiy

Loft

Garage

Kitchen

Where would you like your new boiler to be fitted* This field is required.

Living room

Bedroom

Bathroom

Utiltiy

Loft

Garage

Kitchen

How many bathtubs in total* This field is required.

One

Two

Three +

None

How many separate showers do you have* This field is required. Just showers running off the boiler not electric showers

One

Two

Three

+ More than 3

None

What does the kitchen cold tap run like* This field is required.

Slow

Fast

Rapid

How many Radiators do you have* This field is required.

0 - 5

5- 10

10 - 15

15 - 20

+ More than 20

How many Radiator Thermostats do you have* This field is required.

None

0 - 5

5- 10

10 - 15

15 - 20

More than 20

What Shape is your Flue* This field is required.

Round

Square

Where does the flue exit your home

Wall

Roof

What fuel type do you use* This field is required.

Natural Gas

LPG

Is the gas meter inside or outside* This field is required.

INSIDEOUTSIDE

How far will the new boiler be fitted from the gas supply* This field is required.Gas meter or LPG tank

1 - 3m

3 - 5m

5 - 10m

10 - 15m

15 - 20m

20 - 30m

More than 30 meters

Please tell us your name* This field is required.We won’t tell anyone else

First Name

Last Name

Please leave your phone number if you would like us to call you. (Optional)

Please enter a valid phone number.

Please tell us your Email* This field is required.We need this to send your price

example@example.com

Email Verified

The verification code has been sent to some@email.com
Please check your mailbox and paste the code below to complete verification

••••

Please tell us your postcode * This field is required.

Upload Photos Of Your Boiler* This field is required.TAKE A FEW PICTURES SO WE CAN SEE AROUND YOUR BOILER AND WHERE THE FLUE COMES OUT

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

Boiler Installation Form