| * Installer's Name (First Last Name) |
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| Phone (e.g., 111-222-3333) |
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| * Select Model Number |
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* Serial Number (located on Rating Plate) |
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| * I am a |
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| * Are you a Bosch Registered Service Agent (RSA)? |
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| If Other Tankless, please specify |
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| If Other Tank, please specify |
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| * Location of installation |
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| * Placement of installation |
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| * Number of hot water outlets served by the heater |
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| * Is this the main water heater? |
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| * Purchased from |
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| Dealer Phone (e.g., 111-222-3333) |
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| * How did you locate a dealer for this product? |
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| * How would you rate the Dealer's product knowledge? |
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| * Was this product on display when you purchased it? |
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| If Yes, how would you rate the display? |
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| Phone (e.g., 111-222-3333) |
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| How important were the following possible reasons for selected this water heater? |
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| * What other tankless brands did you consider? |
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| * Why didn't you buy one of the other brands? |
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| * How easy was it to purchase this water heater? |
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| * How easy was it to install? |
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| * How would you rate the price of the Bosch tankless water heater? |
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| * How would you rate the performance? |
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| * How did you learn about this water heater? |
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| If Advertisement/Media, please specify |
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| * Would you recommend this water heater to others? |
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