Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Quilt home survey Help us learn more about you and your home.What is your home address? *Address Line 1Address Line 2CityState / Province / RegionPostal CodeAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountryWhat are the main reasons you’re interested in Quilt? Choose up to 3 *Adding cooling to my homeCutting carbon emissionsSaving money on energyRoom-by-room temperature controlIndoor air quality & healthTaking advantage of tax credits & rebatesCurrent system is having problemsAs part of a renovation projectOtherHow did you originally hear about Quilt? *From a friendOn social mediaIn the pressThrough a search engineOtherI’m not sureSo how’d you hear about us? *Is your home part of a homeowners association (HOA)? *YesNoNot sureDoes your home have ductwork? *Ducts or ductwork are are conduits that move air through your home, typically behind walls. If you have central air or a forced air furnace you probably have ductwork.YesNoNot sureHow many stories is your home? *1 story2 stories3 stories4+ storiesApproximately how many square feet is your home? *Less than 10001000-14991500-19992000-24992500-35003500+I’m not sureHow many bedrooms do you have in your home? *12345+Does your home have solar panels? *YesNoDo you have a home battery? *YesNoNumber of adults in your household *Number of children in your household *What is your approximate household income? *Under $75K$75K-$100K$100K-$150K$150K-$200K$200K-$300K$300K+Prefer not to shareWhat mobile platforms do the adults in your home use? *iOS (e.g., iPhone)AndroidBothOtherHow is the wifi coverage in your house? *All the rooms in my house have great wifiSome rooms have better wifi than othersI have rooms with no wifi coverage at allNot sureWhat is your current source of home heating? *Gas furnaceElectric resistance heating (e.g., baseboard or electric furnace)Fuel oilPropaneI don’t knowSomething elseWhat heating system do you have? *How old is your current home heating system? *1-3 years4-7 years8-10 years11+ yearsI’m not sureHow satisfied are you with your home’s heating system? *1 - Extremely dissatisfied2 - Somewhat dissatisfied3 - Neutral 4 - Somewhat satisfied5 - Extremely satisfiedAny further details about why you feel this way about your heating system?What is your current source of cooling? *Central air conditioningWindow air conditioningPortable air conditionerI currently don’t have coolingSomething elseI don’t knowWhat cooling system do you have? *How old is your current air conditioner? *1-3 years4-7 years8-10 years11+ yearsI’m not sureHow satisfied are you with your home’s cooling system? *1 - Extremely dissatisfied2 - Somewhat dissatisfied3 - Neutral 4 - Somewhat satisfied5 - Extremely satisfiedAny further details about why you feel this way about your cooling system?Do you use a smart thermostat today? *YesNoWhat kind of smart thermostat do you use? *How much of your home are you looking to cover? *My entire homeJust a few roomsOnly one room or spaceI’m not sureOtherHow soon are you looking to install a new system in your home? *As soon as possibleIn the next 3 monthsIn the next 12 monthsMore than 12 months from nowI’m not sureAre you primarily interested in upgrading your heating or cooling? *HeatingCoolingBoth equallyWhat alternatives are you considering beyond Quilt? *Central heat pump (also called “ducted” heat pump)Currently available ductless mini-splitsNew gas furnaceNew central air conditioningOther (please specify)NoneWhat other system are you considering? *What are your cost expectations for the total project, prior to any rebates or incentives? *Less than $5,000$5,000-$15,000$15,000-$30,000$30,000-$50,000Over $50,000I’m not sureAnything else you’d like to add?Submit