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GET IN TOUCH
WATER SURVEY
HOW IS YOUR WATER? TAKE THE TEST TODAY.
WATER SURVEY
HOW IS YOUR WATER? TAKE THE TEST TODAY.
Complete our survey and a representative will get in touch with you to see if we can help you.
Please leave blank:
Do you notice any of the following with your tap water?
Tastes
Odours
Cloudiness
Discolouration
Limescale
Do you feel drugs in your water could be affecting your:
Digestive System
Skin Conditions
Fertility
Other
Do you treat your water in anyway at home?
Jug Filter
Fridge Filter
Salt Softener
Other
How many bottles of water do you buy a week? Please enter a number from 0 to 100.
What age bracket best describes your family?
0 - 15
16 - 29
30 - 40
41 - 60
61 - 69
70 - 75
76 +
How do you rate the quality of your water?
Good
Fair
Poor
Do you own or rent your home?
Own
Rent
How many adults live at the property?
How many children live at the property?
Type of property:
Bungalow
Detached
Semi-Detached
Terrace
Flat
Are you aware of the effects hard water has on your energy costs?
Yes
No
Your name:
Tel no:
House Number:
Postcode:
Send
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