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Service Provider Forms


Forms that all Service Providers are required to complete and submit to the state. Includes the fuel switch request form.

ASHRAE 62.2 Calculation Sheet
Use this worksheet to calculate the ventilation needs for a home.

Blower Door and Pressures
To collect data on on blower door tests and house pressure readings.

Client Education
This form must be signed by the client to acknowledge they understand the list of energy saving items.

Client Preparation
List of requirements and education items to discuss with clients.

Client Refusal
Allows the client to decline weatherization work.

Complaint Description
Use this to document a client complaint on completed weatherization work.

Deferral Form
A checklist with specific conditions that must be met prior to weatherization work.

Final Inspection
This form must be signed by the client to acknowledge they understand the list of weatherization work completed.

FSR Form ARRA Closeout Cumulative
Form to use for financial closeout related to ARRA weatherization work.

Fuel Switch Request
Request form to switch the type of heating fuel used in a home.

Fuel Switching Calculations
Form to determine the life cycle costs of heating fuels.

Garage Zone Pressure
To document pressure and leakage between the garage and house.

Lead Safe Renovation Recordkeeping
Form to document lead safe practices when renovation takes place at a home.

Lead Test Kit Documentation
Fill in details about the owner or occupant and the site to undergo renovation.

Mechanical Testing 
Use to record testing procedures completed on mechanical systems in a home.

Mold and Moisture Assessment
Specific locations in a home to check for mold and moisture.

Notice of Safety Problem
Use this form to document safety hazards in homes.

Out-of-State Travel
Complete and submit this form to request out-of-state travel for a conference or training event.

Renovate Right Signature
Form to document that the homeowner received a copy of the lead hazard information pamphlet.

Scope of Work Change Order
Complete this form if there is a change in scope of work.

SERC Grant Documentation Summary
Form Required by DOE to document all SERC work.

SERC Service Agreement
Agreement between the client and service provider on SERC measures to be completed.

Service Agreement
Agreement between the client and service provider on weatherization measures to be completed.

Shell Data Collection
Sample form for data collection of home shell information to be used with Manual J Software.

Wall Insulation Preparation
Description of the process a crew will go through for wall insulation preparation.