SUPER SERVICE COMFORT &
INDOOR AIR QUALITY SURVEY

Dear Valued Customer,

Our goal is very simple: to keep you, our customer, happy! To help us help you, please complete this short survey and return it before your service technician leaves.

This Comfort & Indoor Air Quality Survey will help us make sure your family's indoor living environment is safe, healthy and comfortable. It will also help us keep your future replacement, repair and utility bills down to a minimum. We sincerely thank you for your cooperation and look forward to serving you again!

Full Name:
Email:
Home Phone:
Address:
City:
State:
Zip:

Does anyone in your home get frequent head-aches, flu-like symptoms, or feel tired all the time?
Yes      No

Does your furniture seem to get dusty within a few days after cleaning the house?
Yes      No

Does water drip off the inside surface of your windows in the winter?
Yes      No

If your home is 2 or 3 stories tall, is your top floor often too hot or too cold?
Yes      No       Not Applicable

If you have a heat pump, does it ever seem to blow cool air in the winter?
Yes      No       Not Applicable

How important to you is lowering your monthly utility bills?
Very      Not Very       Not Important

Does anyone in your home have asthma, or allergies to dust, pollen, or molds?
Yes      No

Is your air too dry in the winter? (static shocks, dry sinuses)
Yes      No

Do you have any uncomfortable rooms? (too hot, too cold, stuffy or drafty)
Yes      No

Does your system ever run non-stop but still not keep you comfortable?
Yes      No

Does noise from your heating and cooling system bother you? (whistling, rumbling)
Yes      No

What do you NOT like about your present heating and cooling system?

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