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About You

Full Name

Cell Phone

Address

City

About Your Home / Office

Style of Your Home / Office

Detached
Semi-detached
Townhouse
Condo
Condo Townhome
Bungalow
Split Level
Duplex, Triplex, Fourplex
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Age of Your Home / Office

Square Footage

Do you have any hot or cold spots in the winter?

Yes

Do you or any family members / employees have allergies or breathing concerns?

Yes

Extra Info

Do you have an operational Hot Tub?

Yes

Do you drive an Electric Vehicle?

Yes

How is the humidity in your house in the winter?

Have you made any energy efficiency updates to your home?

About Your Quote

Which of the following products are you interested in having installed?

Furnace

Air Conditioning

Heat Pump

Commercial Equipment

Maintenance Packages

To make our estimate more accurate, do you have a budget in mind?

Cheap and Cheerful ($)

Middle of the Road ($$)

All the Bells and Whistles ($$$)

How soon are you looking to have this installed?

As soon as possible

In the next couple of weeks

Sometime this season

I'm just researching for now

How did you hear about us? Can we thank someone for referring you?

Additional Comments

Furnace Room and House Photos

For furnace quotes: Please take some pictures of your furnace room and the front of your house and attach them here. We are looking for a wide-view of your furnace room so we can see how your existing furnace vents to the outside. Please attach a picture of the front of your house so we can see where your chimney is. For Air Conditioning quotes: Please include a picture of your breaker panel (both with the door open and closed). Please include a photo of where you would like your outdoor unit placed. We may need to complete a quick virtual call prior to sending you your quote. We'll be in touch! Allowed file types: JPG, PNG, PDF, GIF, HEIC.

Office: Lorem Ipsum

Call (587) 840.6033

Email: sales@samsfix.com

Get a Free Quote

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