EV Charger Installation Request Form

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 NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
How did you hear about us? *
Please tell us how you found us!

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?*
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?*
Where is your proposed location for your EV charger? *
Please indicate or specify if this location is inside outside
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 one of the options from the drop down menu.
What size garage do you have? (For example: 24'x12', or single car garage, or I do not have a garage) *
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 BasementCrawl SpaceAtticOther
Does you house have any of the following? (Please select all that apply)*

Finished BasementSecond StoryPoolHot Tub/SpaDetached GarageAir Conditioning/ Central AirMultiple RefridgeratorsElectric water heaterElectric Stove/OvenElectric DryerSolar PanelsGeneratorBattery Backup systemOther
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) *

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Please take a photo of your main electrical panel from 15-20 feet back to show its location. *

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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)*

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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.

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Please provide us with any other additional images that you think may assist us for your installation.

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Vehicle Info:

Section 3: Please provide your vehicle information.
Do you currently have the Electric Vehicle? *
Vehicle Make*
Vehicle Model*
What type of charger are you looking to get installed? (For Example a level 2 hard wired charger, or a 240V outlet)*
Do you own your charger already or need DMH Electric to provide one in the estimate? (Please select from the drop down menu)*

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 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.)
Should be Empty:

EV Charger Installation Request Form

Contact Information

Home Info:

Vehicle Info:

Installation Preferences: