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Thank you for your interest in working with E3 INNOVATE. To gain an understanding of your home and what it is you are looking to improve, please answer as many questions as possible on this intake form. This will help us determine the best service(s) for your needs.

Click here if you have a NEW construction home

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Name *

First

Last

Address Of Project *

Address Line 1

Address Line 2

City

— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Mailing Address (If Different From Above)

Address Line 1

Address Line 2

City

— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Best Phone Number To Reach You *

Email Address Of Homeowner *

Name, Email & Phone Of Builder *

Name, Email & Phone Of Architect *

Do You Currently Have A Set Of Drawings? If So, Please Email A Copy To Office@e3innovate.com *

• Yes
• No

What Stage Of The Project Are You In? *

• Day-Dreaming: Land is purchased but plans have not been drawn (no architect or builder)
• Architect has completed the first draft of plans
• I have an architect, first draft of plans, and a builder and I’m looking to optimize my design
• Recently broke ground
• Foundation is in progress/complete
• Framing is in progress/complete
• Other

What Are The Primary Goals Of Your Project And Desired Outcomes Of Your New Home? (Select All That Apply) *

• A well designed and engineered home that exceeds building codes
• Zero-Energy Ready
• Passive house strategies
• Home certification such as LEED, ENERGY STAR, HERS, etc.
• Improved indoor air quality
• Even comfort and comfort control
• Humidity control
• Low energy costs
• Reduced environmental impact
• Durability and extreme weather preparedness
• Power back-up
• Low maintenance
• Home automation
• Peace of Mind
• Other…

From The List Above, Please Rank Your Top THREE (3) Motivations In Order Of Importance *

Please Choose The Three Best Times For Your Free 15 Minute Phone Consultation

Date & Time

Date

Time

Date & Time

Date

Time

Date & Time

Date

Time

How Did You Hear About E3 Innovate? *

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Click here if you have an EXISTING home

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Name *

First

Last

Email Address *

Best phone number to reach you *

Address

Address Line 1

City

AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Please select services you are interested in (select all that apply)

• Humidity/Moisture
• Comfort concerns
• Mold/Mildew
• HVAC Performance
• Radon
• Odors
• High energy bills
• Durability / extreme weather concerns
• Sustainability
• Other…

How did you hear about E3 INNOVATE?ReferralLocal NPR radio stationFacebookInternet searchConference presentationOther

If referral, who can we thank for sharing our name with you?

Have you worked with E3 in the past?

Please Choose The Three Best Times For Your Free 15 Minute Phone Consultation

Date & Time

Date

Time

Date & Time

Date

Time

Date & Time

Date

Time

Comments or Questions *

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