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Are you or anyone in your household in receipt of benefits, child care benefits or working tax credits such as these:
Pension Credit
Income based Jobseeker's Allowance
Income Support
Tax Credits (Child or Working Tax Credit)
Universal Credit
Income Related Employment & Support Allowance
Housing Benefit
None
Is your Household income Under £31k?
Yes
No
Do you have any Health Condition?
Limited Mobility
Immunosuppressed
Cardiovascular
Respiratory
None
Please select your heating type
—Please choose an option—
Main Gas Boiler
Electric Storage Heaters
Electric Heating
Solid Fuel
Electric Panel Heaters
Electric Wet Radiators
Warm / Blow Air Heating
I don't have any heating
Are you a homeowner?
Yes
No
Is your boiler more than 15 years old?
Yes
No
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