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Energy Champions energy advice form
If you have any questions about this form please email chris@energiesussexcoast.co.uk
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Energy Champion name
Your answer
Venue
Your answer
Data protection
Please read this statement to your client and get confirmation from them: This information will be stored securely by Energise Sussex Coast for monitoring and evaluation purposes. Data will be anonymised and shared with the National Lottery who fund this programme.
Consent to store information
No consent (please do not fill out this form)
Client name
Your answer
Client postcode
Your answer
Client contact number
Your answer
Advice on saving energy
Tick all that apply
Draught proofing
Hot water cylinder insulation/ pipe lagging
Insulation (loft, walls, floor)
Accessing/ understanding Energy Performance Certificate
Turning down thermostat
Turning down boiler flow (hot water temperature in boiler)
Solar panels
Heat pumps
Other:
Billing and payment support
Help with understanding bill
Support to talk to energy company
Explaining how energy is billed
Advice on energy meters
Advice on switching tariffs
Other:
The Priority Services Register
Add to the PSR: https://www.ukpowernetworks.co.uk/power-cut/priority-services/about-the-priority-services-register?campaign=energisesussexcoast
Added to PSR in advice session
Gave information and client will apply
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Advice on discounts and support schemes
Cheaper water tariff
Referred for fuel voucher (for prepay meters)
Energy trusts for debt write off or white goods
Current government support schemes
Warm Home Discount/ Winter fuel payment for pensioners
Grants for goods
Other:
Signposting/ referred for
Housing advice
Debt advice
Mental health support
Foodbank
Water company support
Safeguarding and hazards (e.g. fire service)
Referral to energy advice service?
Please refer to Energise Sussex Coast's energy advisors for complex cases, energy debt or if a prepay meter voucher is needed.
Yes
No
Clear selection
If referring for energy advice please give some details
Your answer
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