Energy-Efficient Appliance Upgrade Feedback Form
Full Name
Email
Appliance Upgraded
Brand/Model
Reason for Upgrade
Reduce energy consumption
Old appliance replacement
Rebate/incentive offer
Previous appliance malfunction
Other
Satisfaction with New Appliance
Very Satisfied
Satisfied
Neutral
Dissatisfied
Very Dissatisfied
Did you notice a decrease in your energy bill?
Yes
No
Not Sure
Additional Comments / Suggestions