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12
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1
Name
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First Name
Last Name
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2
Post Code
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3
Phone Number
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Please enter a valid phone number.
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4
Email
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example@example.com
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5
What is your highest concern when discussing water quality in your home?
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Unpleasant taste and odor from my tap water
Dry skin and hair after showering or washing
Health concerns such as asthma, eczema, Crohn's disease, or thyroid issues
Limescale buildup and hard water damage
Worries about chemicals like THMs, fluoride, or PFAS in the water
High costs of buying bottled water
Presence of plastics (nano/micro) in water
Safe water for babies and bottle feeding
Desire to support anti-aging efforts
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6
How many people are currently living in your home?
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Two adults and children (e.g., myself, my partner, and our kids)
One adult and children (e.g., myself and up to 3 children)
Two adults, no children (e.g., my partner and I)
Single adult (just me)
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7
How urgently do you need a solution for this issue?
*
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Yes, we need water filtration immediately and want to proceed now.
Yes, we plan to address this in the future.
Not sure yet, just exploring options for now.
No rush, just curious about possibilities.
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8
Is this the first time hearing about whole home water filtration systems?
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I’m confident that this is the ideal solution for upgrading my home’s water.
I understand it’s different from under-sink filtration and would like more information.
I’m undecided and just exploring my options at the moment.
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9
Finding the Perfect Time to Connect
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Early morning (before 9 AM)
Late morning (9 AM - 12 PM)
Early afternoon (12 PM - 3 PM)
Late afternoon (3 PM - 6 PM)
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10
Are you the homeowner or currently Renting the home?
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Yes, I am the homeowner
No, I am renting
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11
Do you currently have a filtered water system within your home?
*
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Yes, we currently have a filtered water tap in our kitchen.
Yes, we currently have a whole home filtration system.
No, we don't have one yet.
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12
We would love to know how you discovered our services
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Google
Facebook
TV
Radio
Online
Podcast
Friends / Family
Influencer
Magazine / Newspaper
Shopping Centre / Home Show
Other
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