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How were you referred to us?
Email
*
example@example.com
Phone Number
*
Format: (000) 000-0000.
Cell Phone Number
*
When is the best time for a phone consult? We will email you within 24 hours, please be sure to check your spam/junk folder, so that we can set up a consult with our Water Quality Specialist.
*
Number of people in the family
*
1-2
3-4
5+
Square Feet of the Home
*
Kitchen has a single or double sink
*
Single
Double
Not Applicable
Countertop material
*
Maximum number of characters: 50
Is the sink under mount or over mount?
*
Under
Over
Not Sure
Is there an instant hot cold dispenser on the sink?
*
Yes
No
Do you have a garbage disposal?
*
Yes
No
Number of bathrooms
*
1
2-2.5
3-3.5
4+
Number of showers in use at the same time
*
Usually 1
Sometimes 2
2 Or More At A Time
Size of your main pipe
*
3/4
1
1 1/2
Not Sure
Material of the main pipe?
*
Copper
PVC
PEX
Galvanized
Not Sure
Do you have municipal or well water?
*
Municipal
Well Water
New House/ Not Sure Yet
N/A
The name of your municipal water company?
*
If a well, please tell us how deep the well is, is it chlorinated, your pump pressure and if you have ever had your well water tested.
*
Maximum number of characters: 100
0/100
Do you have any brown stains or rust on your fixtures?
*
Yes
No
It's A Different Color
Do you have any white scaling on your fixtures, glasses, or pots.
*
Yes
No
It's A Different Color
Are there any objectionable odors or tastes in your water? Are the odors only present when using hot water?
*
Maximum number of characters: 100
0/100
Do you have a sprinkler system?
*
Yes
No
Do you have a basement? If yes, what is the height of the ceiling? Is the main pipe accessible?
*
Maximum number of characters: 100
0/100
Do you have any local concerns? (boil water alert, water alerts, spills?)
*
Maximum number of characters: 100
0/100
Are there any specific times that you will be available. CWR's business hours are M-F 9 am to 5 pm EST.
*
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0/100
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