EV Charger Installation Request Form
Please provide us with as much detailed information regarding your home and electric vehicle so we can better assist you! if you have any questions during this process please email ev@dmhelectric.com.
Contact Information
Section 1: Please Provide your contact information.
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
How did you hear about us?
*
Please Select
Current Customer
Dealership
Facebook
Friend
Google
Instagram
Qmerit
Tesla
Website
Yelp
Other
Please tell us how you found us!
What Dealership Referred you?
*
Back
Next
Home Info:
Section 2: Please provide us with some information about your home.
Tell us about your current living situation. Do you rent or own the property?
*
Please Select
Rent
Own
Do you need to get permission from a landlord, Homeowner Association (HOA) or any other third parties?
*
Please fill in and let us know the situation, if it does not apply to you put N/A
Approximately what year was your home built?
*
What is your home's approximate square footage?
*
Where is your main electrical panel located? (For Example in the garage, basement, outside)
*
What is the size of your main electrical panel? (For Example 100amps, 200 amps, I do not know)
*
Do you have more than one electrical panel in your home? If so, how many?
*
Is your EV Charger going in a Garage?
*
Please Select
Yes
No
Where is your proposed location for your EV charger?
*
Please indicate or specify if this location is inside outside
What size garage do you have? (For example: 24'x12', single car garage, two car garage, Etc.)
*
Is your garage attached or detached?
*
Please Select
Attached
Detached
Is your proposed location for your EV charger on the same wall as your main electrical panel?
*
Approximately how far is the proposed location from the main electrical panel?
*
Please Select
Less than 10ft
11-25ft
26-49ft
50-74ft
75-100ft
Greater than 100ft
Please select one of the options from the drop down menu.
What type of access does our technician have when working between the main electrical panel and the proposed charging location? (Please select all that apply)
*
Unfinished Basement
Crawl Space
Attic
Other
Does you house have any of the following? (Please select all that apply)
*
Finished Basement
Second Story
Pool
Hot Tub/Spa
Detached Garage
Air Conditioning/ Central Air
Multiple Refridgerators
Electric Water Heater
Electric Stove/Oven
Electric Dryer
Solar Panels
Generator
Battery Backup system
Electric Heat
Electric Heat Pump
Other
When standing in the driveway facing the garage, which wall do you want the charger installed on? If you do not want the charger in the garage, when facing your home which side of the house will the charger be installed on?
*
Please provide us with an image of the entire area where you would like your charger to be installed. (Step back about 10-20 feet from preferred installation spot)
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Please take a photo of your main electrical panel from 15-20 feet back to show its location.
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Please provide us with a close up photo of your electrical panel with the door open, and capture the full panel so the installer can see the main breaker and all the panel slots. (Make sure the photo is not blurry so we can read the labels on the panel)
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Please locate the round electrical meter (likely located on the side of your home). Please take a photo of it standing back far enough that it also captured the ground and roof line.
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Please provide us with a sketch of the floor plan of your home. Include rough measurements, the location of the panel, general layouts of the home, proposed EV charger location, and any other details (doors, windows, garage, finished or unfinished areas)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Please provide us with any other additional images that you think may assist us for your installation.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Back
Next
Vehicle Info:
Section 3: Please provide your vehicle information.
Do you currently have the Electric Vehicle?
*
Please Select
Yes
No, it is on order
No, I am looking to purchase
Other
Vehicle Make
*
Vehicle Model
*
What type of charger are you looking to get installed?
*
Please Select
240v Outlet (For plug-in chargers)
Hardwired EV charger
Do you own your charger already or need DMH Electric to provide one in the estimate? (Please select from the drop down menu)
*
Please Select
Yes, I already have one.
Yes, it is on order.
No, Please provide one.
No, please provide me with some guidance and I will buy one.
Back
Next
Installation Preferences:
Section 4: Please help us find a good time from your installation!
If additional information is needed for us to provide you with an accurate estimate, please select your preferred method.
*
Please Select
Quick home visit (Under 30 minutes)
Video call (Virtually walk us through your home)
Email (we will request additional information)
Please let us know your schedule/ best days or times for installation.
*
While we are at your home, do you need any additional electrical work completed? (For Example: Replace smoke detectors, update lighting, replace outlets, generator service or installation, Etc.)
*
We can provide an estimate for additional work and include it with our proposal.
Any Additional information that you would like to provide us with? (Personal, home vehicle, etc.)
Submit
Should be Empty: