Test Results Entry Form

1
DR Radiator

Home Heating Test Kit
Entry Form.

Before you start...

You will be asked to verify as a human.

It is important to have your Home Heating Test Kit's "UNIQUE IDENTIER," number to hand. This can be found on your invoice.

Ensure you have your "TEST CARDS," ready.

And, that each test card colour option has been "TICKED," with the relevant number option as this will be entered on the entry forms.

Before making each entry, you will be asked to confirm you have the correct test card.

Before submitting your Test Results you will be allowed to "REVIEW," your answers. If you do not wish to "REVIEW," your answers you will skip directly to "SUBMIT."

Only "SUBMIT," when you are confident that you have correctly entered the details, as "SUBMIT," is final. The entries or report cannot be amended and your results may be inaccurate.

When you have entered all test cards correctly, click the "SUBMIT," button to see your report.
2
Please verify that you are human* This field is required.
3
Unique Identifier
4
Insert Your DR Radiator Account NumberThe one from registration form. You can skip this if you don't remember.
5
Customer Name* This field is required.
First Name
Last Name
6
Email* This field is required.Insert your email address. This will be use to see your dashboard.
example@example.com
7
Home Test Kit Unique Identifier* This field is required.You can find your unique identifier on your invoice,
8
The first card you will submit will be for the Tubidity test card.Please check you have the correct Test Card to hand.
9
Turbidity Test Card Entry.* This field is required.Please confirm you are entering test results for the Turbidity test card
Yes
No
10
Turbidity Test Strip Result* This field is required.Please select the number option for the colour which best matched your Turbidity Test Stick at the time of "Dipping."
Please Select
Please Select
1
2
3
4
5
6
7
8
9
10
11
The second card you will submit will be for the Inhibitor test card.Please check you have the correct Test Card to hand.
12
Inhibitor Test Card Entry* This field is required.Please confirm you are entering test results for the Inhibitor test card
Yes
No
13
Inhibitor Test Strip Result* This field is required.Please select the number option for the colour which best matched your Inhibitor Test Stick at the time of "Dipping."
Please Select
Please Select
1
2
3
4
5
6
7
8
9
14
The third card you will submit will be for the Ph test card.Please check you have the correct Test Card to hand.
15
Ph Test Card Entry.* This field is required.Please confirm you are entering test results for the Inhibitor test card
Yes
No
16
Ph Test Strip Result* This field is required.Please select the number option for the colour which best matched your Ph Test Stick at the time of "Dipping."
Please Select
Please Select
1
2
3
4
5
6
7
8
9
10
11
12
13
14
17
Review Your Answers?Now would be a great time to ensure your answers are correct!
YESNO
18

You're Done!

{customerName}

{homeTest}

Thank You for purchasing your DR Radiator Home Heating Test Kit and using our online results system.

The Doctor is reviewing your case now!

Please click NEXT to see his report.

Don't forget to check out Dr Radiator's other services and use the inbox money-back vouchers.
Should be Empty: