Operation Weatherization Survey - Heart of Indiana United Way

1. Which of the following weatherization products did you use? *

2. Did you receive a Reflectix Water Heater Insulation Kit? *

Yes
No
Did not request
Was not offered/available

If yes, did you use the Water Heater Insulation Kit? *

Yes
No

3. Do you feel the products you used LOWERED your energy bills this past winter? *

Yes
No

Would you mind telling us why?

4. Do you feel the products you used made your home WARMER this past winter? *

Yes
No

Would you mind telling us why?

5. Which products HELPED you the most? *

6. What products would you like to see ADDED to the box? Why?

7. I was ABLE to install/use the products... *

By myself
With help from someone in my household
With help from someone NOT in my household

8. I was UNABLE to use the products because: (Check all that apply) *

County I live in: *

To receive a chance to win a $50 grocery store gift card, please provide your name and phone number or email.
Your contact info will only be used if you are a gift card winner.

Name *

First

Last

Email

Phone