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• Do you own the property?
  
  Yes No N/A

• 1) Do you have loft insulation? No At least 50mm of insulation across part of loft space At least 50mm across all loft space At least 50mm across all loftspace and 270 mm across some 270mm across entire loft

• 2) Does your home have cavity wall or solid wall insulation?
  
  Yes No N/A

• 3) What percentage of your external doors and windows and ground floor floorboards have been draft-proofed?
  
  0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

• 4) What percentage of your pipes and watertank are insulated?
  
  0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

• 5) Have you installed an A-rated boiler in your home?
  
  Yes No N/A

• 6) What proportion of your total energy consumption comes from onsite generation? (eg solar, wind, heat pumps etc)
  
  0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

• 7) Are you connected to a green energy tariff? No Electricity or Gas Only Both Electricity and Gas

• 8) What proportion of your home has double glazed windows?
  
  0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

• 9) What proportion of your lightbulbs are energy efficient?
  
  0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

• 10) What proportion of your white goods (like washing machines) and electronic goods are A-rated/Energy Star rated or similar?
  
  0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Finally, please give us a little more detail (in no more than 250 words) about what you do about energy efficiency in your home.

e.g. I put up reminders around the kitchen to wash at 30 degrees.

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