AirOne Heating and Air Conditioning

*First Name:

*Last Name:

*Address:

*City:

*State/Province:

*Postal Code:

*Email Address:

*Phone Number:

Do you own or rent your home?

Own

Rent

*How long do you plan to live in the home?:

*How long have you currently lived in your present home?:

*Do you know how old the home is and the year it was built?:

Do you know how old the furnace is in the home?:

*Do you have central air? If so, how old is your system?:

*Has the home ever had insulation added to it? If so, when and where was it added, and what was the factory rating?:

*Has the home ever had new windows and doors? If so, when and where were they added, and what's their factory rating?:

Has the home ever had air sealing and penetrations caulked? If so, when and what factory rating?:

*Has the home been remodeled? If so, when?:

*Do you have any future plans to remodel?:

*How did you come to choose AirOne Air Conditioning?:

*Why are you considering a new comfort system?:

*Are there any hot/cold spots in the home, or areas that may not be even in temperature?:

Are you interested in a cheaper system or the best value available to you?

Cheapest

Best Value

*Please check the items on the list that are important to you.

Quality Products

Quiet / Low Sound

Low Monthly Payments

Safety

Appearance with Home

Lowest Operating Costs

Low Future Repair Costs

Newest Technology

Energy Tax Credits

Fuel Options / Choices

Return on Investment

Environmentally Friendly

Saving Money on Utilities

High Efficiency Products

Least Expensive Price

Best Warranty & Guarantee

Financing Flexibility

Brand Name Options

After the Sale Service

Better Indoor Air Quality

Rebates / Incentives

Comfort in Your Home

*Of the options mentioned above, please list your top 5 priority from 1 being the most important to 5 being the least.:

*Does anyone in the family have allergies or appear to be suffering? If so, how severe are the allergies?:

Are you familiar with the Energy Star program from the EPA or the Energy Tax Credits available to you?

Yes

No

*What budget range did you have in mind?:

About what can you afford monthly?:

If AirOne can design the best system that meets all your family needs and provide comfort, energy savings, the safest and reliable system, can we ask you for the business today?

Yes

No