Enrollment Number
*
Name
*
First
Last
Daytime Phone Number
*
Format: (000) 000-0000.
Email
*
How would you rate your overall satisfaction with our services?
Worst
1
2
3
4
Best
5
1 is Worst, 5 is Best
How likely are you to recommend this program to friends and family?
Worst
1
2
3
4
Best
5
1 is Worst, 5 is Best
Did the contractor(s) thoroughly explain the program and tell you specific ways to save energy?
Yes
No
Did the contractor(s) appear professionally?
Yes
No
Did the contractor explain what they were installing?
Yes
No
Did the contractor treat the property with care and clean up after their work?
Yes
No
Was your home weatherized in a reasonable amount of time?
Yes
No
How satisfied were you with the performance and quality of the energy-efficient improvements installed in your home?
Worst
1
2
3
4
Best
5
1 is Worst, 5 is Best
Please Provide Us Feedback From Your Assessment
Would you like to be contacted by a Program Manager regarding your feedback?
Yes
No
Reply To Address
Submit
Should be Empty: