EV Pre Install - DSG Electrical Services

Customer Details

Customer Name

Survey Date

Address

Postcode

Phone Number

Email Address

Engineer Name

Vehicle Make & Model

Battery Capacity, if known

Charger Make & Model Requested

Charging Output Required

Tethered or Untethered
Tethered
Untethered
Not confirmed

Smart Charging Required
Yes
No
To discuss

Notes

Installation Suitable

Estimated Installation Time

Quoted Price

Materials Required

Follow-Up Actions

I confirm the information provided is accurate to the best of my knowledge.

Customer Signature / Name

Date