NH Power Workshop
Event Timing & venue: See your email invite 

Contact us: admin@nhpower.net
Visit our website: www.nhpower.net

Your email address (this is the address that we will send your initial site assessment to)  Your email will not be distributed to third parties.
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Pre Event Questionnaire
This questionnaire is designed to collect the minimum data needed in order to start preparing an outline viability for your site, with the aim of indicating what decarbonising heat at your site could potentially look like, and to give you an idea of the potential level of decarbonisation delivery and costs, and ability to meet both NHS near term carbon reduction targets and 2040 net zero. 

Once you have filled out and submitted this questionnaire, we will prepare your own bespoke indication report which you will be able to finesse whilst attending the workshop. 

Please note that you can respond to this questionnaire multiple times, if you have more than one site within your Trust, or if you want to consider different renewable heat options e.g. one response for geothermal and submitting another response that selects hydrogen. 
Enter your name *
Enter your job title / position low
Enter the name of the Trust that you work for *
Choose your site name from the list below. (if your site is not shown, select "OTHER - SITE NOT LISTED" from the dropdown below). *
Enter the name of your site here, if it is not listed in previous question list (or if you are unsure whether it is correctly listed or not):
Enter the site's post code here. *
Enter approx. gross internal floor area of facilities here (m2)
Chose the geographic region that best describes your site's location *
Enter the approximate proportion of your site that is heated from a centralised boiler house (or energy centre). This means that a single heating plant facility is located on your site, from which heating pipes are distributed to serve local plant rooms within either some, or all of your site buildings. *
Select the type of heating that best describes the heat delivered to the majority of your site from the list below *
Select the approximate typical fossil fuel heating boiler seasonal efficiency from the options below that best represents the majority of plant serving your site. *
Is your existing energy centre at end of life? *
Select the approximate proportion of your site that has already had its building lighting upgraded to LED fittings *
All of our lighting has been converted to LED *
Are you interested in converting your heat distribution to LTHW? *
Are you interested in Improvements to ventilation plant (AHUs)? *
Are you interested in replacing existing building management / controls equipment with new systems? *
Are you interested in optimising existing building management / controls? *
Are you interested in large scale solar PV (this is solar PV beyond just roof mounting and likely to require significant carparking areas for array mounting or spare open areas or adjacent or off site land availability)? *
Are you interested in air source or ground source heat pumps? *
Are you interested in either of the following renewable / low carbon heat services? *
Required
Please identify if any backlog maintenance sums may be considered as savings against any plant superseded by potential new low carbon energy sources or demand side energy saving measures identified above? E.g. connection to new district energy service avoids replacement of 1x life expired duty gas boiler at £xxx.
Are you ready to proceed financially with a decarbonisation scheme? If there are particular issues please outline them briefly below:
Which of the following, best describes your position on making plans to decarbonise your heat utilisation:
*
Add in any comments or questions that you would like help with answering concerning the potential decarbonisation of your site here.
By submitting this form I consent to being contacted by NHPower, in connection with the objectives of this IHEEM workshop. NHPower will not pass on your details, or any information submitted on this form to any third party without your permission.
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A copy of your responses will be emailed to the address you provided.
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