Request for more information on reducing energy bills and being warm and well at home

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* 1. Would you like to be contacted with advice on reducing your energy costs and being energy efficient in your home?

Yes

If you tick yes, Yorkshire Energy Doctor will contact you about your home energy needs.

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* 2. Please provide the following details:

Name *

Postcode *

Email Address

Phone Number *

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* 3. Please tick any of the following that apply to you:

I find my energy costs expensive

I am in debt with my energy supplier

My home is often cold

I cannot afford to heat my home

I have problems with my heating system

I live in a home with damp problems, mould or poor insulation

Any additional information

By providing your details above and submitting this form you are agreeing to us contacting you for the purpose of providing advice and support related to the Warm and Well North Yorkshire project. We will not share your information with any other third parties