Energy Saving for All

Energy Saving for All is a project delivered by Changeworks and the Council for Ethnic Minority Organisations (Scotland) and is designed to help people to access energy advice.

We are going to ask you some questions to find out what you’re interested in and how we can best help you today. We will be able to give some information today but we may need to follow-up if you need more in-depth advice and information.

First, please provide us with your contact details and some extra information that our funders want us to report on to measure impact. Then let us know what you need help with or want to find out more about.

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Source

Privacy Notice

Privacy Notice and Consent

Changeworks will use your personal data, with your consent, to contact you, make referrals, and provide tailored energy support and advice. We will share anonymised data with British Gas Energy Trust, the project funder, and may also share it with auditors and referral or research partners.

Special category data: We will collect health and ethnicity information to support referrals and anonymised reporting. This data will be processed with your explicit consent or where there is a substantial public interest.

The project runs until 31 March 2027. Your data will be retained for up to one year afterwards for monitoring and evaluation, after which it will be anonymised.

For more information, please see our privacy policy on our website. You can withdraw your consent at any time by contacting us at asklcc@changeworks.org.uk.

We will also ask about your health and ethnicity data for anonymised reporting purposes. This information will be held for six months after the project end. After this, it will be deleted.

Communication Preferences

How do you want to be contacted in the future?

To provide the additional information, make referrals you have requested, and send a short follow-up questionnaire.

Can Changeworks contact you in the future?(Required)

Yes

No

Please tick your preferred methods of contact – note that we may contact you via either channel if required:(Required)

Email

Phone

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When is the best time to call you?

Morning

Afternoon

Evening

Which event/group were you attending when you completed this form?(Required)

Event Staff Member/Volunteer(Required)

Personal Information

Do you require translation services?(Required)

Yes

No

For which language?(Required)

Which age group do you fit into?(Required)

How would you describe your ethnicity?(Required)

White – Scottish or British

White – Other

Mixed or multiple ethnic group

Asian, Asian Scottish or Asian British

Black, African, Caribbean, Black Scottish or Black British

Arab, Arab Scottish or Arab British

Other ethnic group

Prefer not to say

How would you describe your gender?(Required)

Male

Female

Prefer not to say

Other

For the property where you live, which of the following are you?(Required)

Private tenant

Local Authority (council) tenant

Own property outright

Mortgage holder

Housing Association tenant

Other

How many adults and children live in your household?(Required)

Please tick below if you would prefer not to say

I would prefer not to provide the number of adults and children in my household

Is the oldest person in the household aged 16-24 years old?(Required)

Yes

No

Prefer not to say

What is your employment status?

Self-employed

Full-time employment

Part-time employment

Zero hours contract, temporary or seasonal

Unable to work

Other

Please provide details:

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Do you have access to the internet?(Required)

Yes

Yes – but I need support to use the internet

No

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Please describe any language/accessibility requirements that you have:

Additional details

Does one or more of the following relate to you or other people in your household?(Required)

Are you on a pre-payment meter(Required)

Yes

No

Who is your energy supplier?(Required)

Other Energy Supplier(Required)

How would you rate your mood and wellbeing today?

How positive are you about your future wellbeing?

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The Warm Home Discount is a one-time £150 discount off your electricity bill. Please confirm:(Required)

I have received the Warm Home Discount

I intend to apply for it

I have not received it / do not know

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Are you on the Priority Services Register?(Required)

Yes

No

Do not know

I would like a call to sign up

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Do you live in a rural area?(Required)

Yes

No

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Is you property off mains gas?(Required)

Yes

No

Energy use at home

What will you do to help reduce energy use at home?

	Going to try this
Wash clothes at 30 degrees
Line dry your clothes outside instead of using a tumble dryer
Avoid standby and turn off appliances / TV / computers when not in use
Only fill the kettle up with as much water as you need
Turn off your lights when you’re not in the room or don’t need them on
Replacing all your lighting with LEDs will cut your lighting bill by around 50%
Choosing an A-rated fridge freezer over an F-rated model could save you money and energy
Choose a laptop over a desktop
Turn down your heating thermostat by one degree
Reduce your shower time by one minute

Referrals for Support Packs

Warm Packs provide small energy efficiency measures to individuals who meet the eligibility criteria. Orders come from the supplier GTI Direct. For information on how GTI Direct handles personal data, please see their privacy policy on their website. Packs are sent by tracked Royal Mail delivery.

If you intend to use these measures in your own home and would like to be referred for a Warm Pack, please indicate below that you agree for Changeworks to share your contact details with GTI Direct for this purpose only:(Required)

Yes

No

Did Changeworks staff member provide a free hot water bottle to help keep warm?(Required)

Yes

No

Further Support

We may also offer to pass your contact information onto other services, who can provide additional advice and support.

Home Energy Scotland is funded by the Scottish Government and managed by the Energy Saving Trust. An advisor from Home Energy Scotland can advise on saving energy, reducing fuel bills and keeping warm, and assess for any extra support that may be available.

Our Affordable Warmth Advisors can support you to keep your home affordably warm and dry, understand energy bills and manage energy debt.

If you would like to be referred for further support and agree for Changeworks to share your contact details with them for this purpose only please indicate below:

Home Energy Scotland:(Required)

Yes

No

Affordable Warmth Services (if it is available in your area):(Required)

Yes

No

Green Energy Helpline (if it is available in your area):(Required)

Yes

No

Priority Services Register

Yes

No

Please provide the reason for the referral and any additional information to help with referrals/follow ups below:

	0	1	2	3	4+
Children under 5
Children aged 5-18
Adults aged 19-63
Adults aged 64-74
Adults aged 75+

Energy Saving for All