Electrician Intake Form
(For collaboration and referrals on Lutron & Home Automation projects)
Basic Information
Name
*
First Name
Last Name
Business Name (if applicable):
Phone Number
*
Email
example@example.com
Location/Service Area
*
Website/Social Media (if available)
Experience & Qualifications
How many years have you been working as an electrician?
*
Please Select
0-2 years
3-5 years
6-10 years
10+ years
Are you licensed and insured
*
Please Select
Yes
No
What types of projects do you typically work on?
*
Please Select
New Construction
Remodels
Residential
Commercial
Custom Homes
Other: ________________
(Check all that apply)
Do you have experience installing smart home systems (e.g., Lutron, Control4, Crestron, etc.)?
*
Please Select
Yes, I have installed them before
No, but I’m interested in learning
No, and I’m not interested
Are you familiar with low-voltage wiring and integrating automation systems with electrical work?
*
Please Select
Yes
No
Have you worked with builders or general contractors who request smart home solutions?
Please Select
Yes
No
Work Quality & Reliability
Do you have any client references or past project photos you can share?
*
Please Select
Yes
No
How do you typically communicate with clients and contractors on a project?
*
Please Select
Phone Calls
Email
Text Messaging
Other: ________________
What’s your typical availability for new projects?
*
Please Select
Immediate Availability
1-2 Weeks Out
3+ Weeks Out
Collaboration & Growth
Would you be interested in learning more about integrating Lutron automation into your services?
*
Please Select
Yes
No
Are you open to collaborating on projects where smart home automation is needed?
*
Please Select
Yes
No
Do you see value in offering smart home solutions to increase your revenue and get more referrals
*
Please Select
Yes
No
Anything else you'd like to share about your experience or interest in smart home automation?
Submit
Should be Empty: