Gas Central Heating – Boiler – Fire Installation Survey form Name *FirstLastAddress *Address Line 1Address Line 2CityState / Province / RegionPostal CodeHome Phone Contact *Other Phone Contact NumbersEmail *Type of remdial C/Heating work required *Survey for Gas HE Central Heating Boiler ReplacementSurvey Gas Warm Air Central Heating Gas FireSurvey for Heating System AlterationsCentral Heating Filter & Chemical System flush & treatmentAdditional Thermostatic Radiator Valves (Standard or Smart)Pressure control of refilling of boiler & system, (stops over pressurisation)Heating Control System or security floodlightWarm Air Aquair Heat Interface with combi/boilerCooker InstallationNatural Gas or LPG (Liquid Petroleum Gas -Calor /Propane etc )Landlords SectionSurvey Landlord Boiler ReplacementSurvey for smart control systemMore detailed information ring or email Select Post Code Area we cover *LA1 - LA11 AreasLa23 AreaFY2 - FY5 - FY6 - FY7PR4 2 & PR3 AreaCustomers Proposed Date. Please book 3 - 4 working days in advance,thanks *DD12345678910111213141516171819202122232425262728293031/MM123456789101112/YYYY2019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Please select a weekday Mon -Friday - We will reply by email to whether that day or AM PM is available, if not we will suggest another dayChoose Monday - Friday *MondayTuesdayWednesdayThursdayFridayAll bookings have to confirmed by THS Heat to agree on dates, we reserve the right to alter dates ,but will always try to stick to original bookingAm Surveys *AM 9.00 - 12.00ask for pm special arrangement 12.00-3.00pmAM = 8.30 - 12.00 PM please ask Have you used THS Heat before *YesNo Recommended word & mouthComment or MessageCaptcha * = MessageSubmit
