Energy Efficiency Planning Survey Form
Help us assess your current energy usage and identify opportunities for improved energy efficiency.
Organization or Respondent Name
*
Email Address
*
example@example.com
Facility/Building Type
*
Please Select
Residential
Commercial
Industrial
Institutional
Other
How would you rate your current level of energy efficiency?
*
1
2
3
4
5
Please indicate the presence and usage level of the following energy-consuming systems in your facility.
*
Rows
Present?
Usage Level
Lighting
1
Low
Moderate
High
Heating/Cooling (HVAC)
2
Low
Moderate
High
Water Heating
3
Low
Moderate
High
Office Equipment
4
Low
Moderate
High
Machinery/Production Equipment
5
Low
Moderate
High
Other
6
Low
Moderate
High
Which of the following energy efficiency measures have you already implemented? (Select all that apply)
LED lighting
Programmable thermostats
Building insulation upgrades
Energy-efficient appliances
Solar panels or renewable energy
Regular maintenance of equipment
Other
How important are the following factors in your energy efficiency planning?
*
Rows
Not Important
Somewhat Important
Very Important
Reducing costs
7
8
9
Reducing carbon footprint
10
11
12
Improving comfort
13
14
15
Complying with regulations
16
17
18
Enhancing property value
19
20
21
What are the main barriers to improving energy efficiency in your facility? (Select all that apply)
Lack of information
Upfront costs
Lack of technical expertise
Disruption to operations
Limited staff resources
Other
Are you interested in receiving recommendations or assistance for energy efficiency improvements?
*
Yes
No
Maybe
Please share any additional comments or specific goals regarding your energy efficiency planning.
Submit Survey
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