Tell us about your home:
How many years have you lived in this home?:
How old is your furnace?:
What prompted you to consider replacing your system now?:
How old is your air conditioner?:
What temperature do you keep your thermostat set at in the winter?:
What temperature do you keep your thermostat set at in the summer?:
Does your system achieve your desired comfort?:	Yes No
Are there any uncomfortable hot or cold spots in your home?:
Approximately what is your monthly (gas - oil - electric) bill?:
Are you comfortable with the humidity year 'round?:	Yes No
How long do you think you will continue to live in this home?:	0-3 Years 3-6 Years 6-9 Years 12 Years or more
Which people in your family suffer from allergies, asthma, hay fever or sinus problems?  How severe are the symptoms?:
What budget do you have in mind for your new system?:	$2,000 - $3,000 $3,000 - $4,000 $4,000 - $5,000 $6,000 - $7,000 $7,000 - $10,000 $10,000 or more
What is the most you could afford on a weekly basis?:	$15 $25 $35 $45 or more
Contact Information:
Name:	* required
Address:
Phone:	* required
E-mail Address:	* required
Best way to contact you:	E-mail address Phone Mailing Address