Spray Foam Insulation Assessment Form

Any personal information you provide in this assessment form will be handled securely and in accordance with UK GDPR requirements and applicable data protection laws. Please answer only the questions you know the answers to. It is not necessary to answer every question.

Client Details

Full NamePhone NumberEmail AddressProperty AddressPreferred Contact MethodBest Time To Contact

Installation Details

Currently Has Spray Foam?Where InstalledApproximate Installation YearInstaller / Company NamePaid Using Finance?Amount paidFinance Company

Issues Experienced

Sale Information / Mis-selling Indicators

Warned About Mortgage / Sale Risk?Information Provided At Sale

It would increase property value Mortgage lenders fully approve it It was government approved It would save substantial energy costs There were no risks

Mis-selling Indicators

Pressure into agreeing to installation Elderly or vulnerable homeowner No ventilation discussion No roof survey conducted

Documents and Losses

Documents AvailableFinancial Loss Suffered?Financial Impact Items

Money Expended / Loss Estimate

Approximate figures are enough. These are used to estimate an initial compensation range only.

Installation Cost Paid (£)Deposit Paid (£)Finance Payments Made (£)Outstanding Finance Balance (£)Removal Quote / Removal Cost (£)Surveyor Report Cost (£)Roof Repair / Remedial Cost (£)Legal / Professional Costs (£)Estimated Property Value Reduction (£)Other Losses (£)

Explain Other Losses / Financial Impact

CRM Intake Details (For internal company use only)

Lead SourceInitial CRM StatusInternal Notes

Brief Explanation

Evidence Uploads

Allowed: PDF, DOC, DOCX, JPG, JPEG, PNG, HEIC, TXT, MSG, EML. Maximum 10 files, 15MB each.

Upload Evidence Files

Mandatory GDPR Consent

I confirm that the information I have provided is true to the best of my knowledge, and I consent to it being processed, shared with relevant third parties where necessary for the assessment of my dispute, and to being contacted by telephone, email or post regarding my assessment and related services.Electronic Signature