Request an Energy Survey 
Thank you for your interest in the Leaky Homes Roadshow,  delivered by Energy Action Redhill and Reigate Ltd. We are a community benefit society that is working to improve the energy efficiency of homes and buildings within East Surrey.  

The energy surveys and smart packs are possible thanks to funding from the Department for Energy Security and Net Zero and UK Power Networks.   Because of this funding all surveys are free of charge.  However, EARR would welcome donations from those who can afford it.   A donation of £25 would enable EARR to provide an energy survey to an additional household.

Please complete the form below.  All fields marked with a * are required and must be filled.  All data will be handled in accordance with data protection laws.  It will only be used by EARR for the purposes of offering energy efficiency advice and materials.  Within the form we ask your permission to provide your name and contact details to our funders for the purpose of customer satisfaction surveys.  Your permission is entirely voluntary and does not affect eligibility for the Roadshow.

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Email *
About You
If you are completing the form on behalf of someone else, please provide your own name, contact details and organisation (if relevant) in the box at the end of the form.
Your name *
Postcode *
First line of address *
Town/Village
Phone number *
Preferred day(s) for visit - we will contact you to confirm the date and time
My housing status in relation to the above property is *
Tailoring your Energy Advice
So our Energy Champions can offer you the right individual advice it is helpful to know what your priorities are, whether you have any particular concerns and a bit of background on your current energy use.
How important are the following factors in you seeking energy advice? 
Very important
Important
Not as important
Lowering Bills
Keeping my home cosy
Cutting carbon emissions
Clear selection
Please give details of any particular concerns that you would like our Energy Champions to investigate e.g. rooms that don't heat properly, draughty spots etc.
Knowing how much energy you use is really helpful to assess whether you have high usage.  This could affect the suggestions we give on how to lower your bills.   You will find this information on your bills.  The "estimated annual use" is fine.  If you don't have this now, please try to have it to hand when the Energy Champion comes to your home.
Annual electricity use (in kWh)
Annual gas use (in kWh) - if applicable
Annual oil use (in litres) - if applicable
Eligibility
Our funders are prioritising target audiences that will benefit most from energy surveys.  Your information will be stored securely in line with special category data rules.
House type *
Does your home have gas central heating? *
What is the Energy Performance Certificate rating of your home?  (Check here if you are not sure: https://www.gov.uk/find-energy-certificate) *
Is your home in a conservation area?  (See Reigate & Banstead planning website here)  *
What is your ethnicity? *
Is English the first language in your home? *
Does anyone in your home receive disability benefits? *
Would you say you are *
Terms & Conditions
  1. The surveys will be carried out by trained Energy Champions, not Retrofit Assessors or heating engineers.    Requests or calculations beyond the scope of their training will need to be referred to an appropriate professional.  Any suggestions made by Energy Champions should not be relied upon when purchasing goods or services.
  2. Any insulation or energy efficiency measures provided through this offer are for the householder's use only, within their own home.  
  3. Neither Energy Action Redhill and Reigate, nor its directors, accept any liability for issues arising from the survey or the use of energy efficiency measures provided through the Leaky Homes Roadshow.     
I confirm that I have read and accept the Terms & Conditions of this offer
 *
Data Protection
This offer is being funded via Surrey County Council and by UK Power Networks, who are regulated by OFGEM.  Our funders are keen to monitor the quality of the service EARR is offering, so you may be randomly selected to be contacted for a customer satisfaction survey.  This is an important way to demonstrate the difference that the Leaky Homes Roadshow is making to the community. You may request to be excluded from this survey at any time.  
I confirm that my contact details only may be passed to the project funders for the purpose of customer satisfaction surveys. *
Where did you hear about this service?
Clear selection
Any further information that you think may be useful or comments/questions.   (If you have completed the form on behalf of someone else, please provide your own name, contact details (and organisation) here. 
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