Test Results Entry Form

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Please Enter Your Test Kit ID* This field is required.This is the number on the rear of your box.
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Terms and Conditions* This field is required.
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DR Radiator

Home Heating Test Kit
Entry Form.

Before you start...

You will be asked to verify as a human.

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 have the option 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.

After submitting your results check your emails for instructions on how to access your dashboard report and begin to journey to recovery.
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Please verify that you are human* This field is required.
5
Customer Name* This field is required.
First Name
Last Name
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Email* This field is required.Insert your email address. This will be use to see your dashboard.
example@example.com
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Customer Type* This field is required.
Trade Customer
Home Owner
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The first card you will submit will be for the Tubidity test card.Please check you have the correct Test Card to hand.
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Turbidity Test Card Entry.* This field is required.Please confirm you are entering test results for the Turbidity test card
Yes
No
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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
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The second card you will submit will be for the Inhibitor test card.Please check you have the correct Test Card to hand.
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Inhibitor Test Card Entry* This field is required.Please confirm you are entering test results for the Inhibitor test card
Yes
No
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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
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The third card you will submit will be for the Ph test card.Please check you have the correct Test Card to hand.
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Ph Test Card Entry.* This field is required.Please confirm you are entering test results for the Inhibitor test card
Yes
No
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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
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Review Your Answers?Now would be a great time to ensure your answers are correct!
YESNO
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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 check your emails to get instructions and login details to access your dashboard report.
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DashBoard Code
Should be Empty: