SkySaver Customer Consultation Questionnaire Welcome to your SkySaver Customer Consultation Questionnaire 1. How many people reside in the home permanently or stay there occasionally? 2. Please list details for each person who may need to use the device: Harness Type / Age / Est. Height / Est. Weight / Mobility Limitations. (Users within 50-120 kg and 150-210 cm may write 'Basic' for harness type) 3. If any individuals have mobility limitations, please describe them (e.g. wheelchair user, limited mobility, visual impairment). 4. What is the primary construction material of the building? Brick Wood Other (please specify) Don't know None 5. How old is the building? 0-20 years 21-40 years 40+ years Don't know None 6. How many floors does the building have? (Approximate building height in meters if known) 7. Which fire hazards are present in the building? (Select all that apply) No fire hazards High-activity kitchen Space heaters / Fireplaces Aging electrical wiring E-bike / Scooter charging Gas appliances Flammable materials storage Other (please specify) 8. Is there a fire detection system (smoke/heat alarms) installed? No Yes — please specify type in comments None 9. Is there a fire suppression system (sprinklers) installed? No Yes — please specify type in comments None 10. What best describes the regional weather where the building is located? Changes by season Mostly cold Mostly hot Don't know None 11. How would you describe the building's location? Urban / City Rural Other (please specify) None 12. Window 1: What is the window size? (Width × Height in cm or mm) 13. Window 1: Distance A — top of window frame to ceiling (in cm or mm) 14. Window 1: Distance B — floor to bottom of window sill (in cm or mm) 15. Window 1: Distance C — left side of window frame to nearest wall (in cm or mm) None 16. Window 1: Distance D — right side of window frame to nearest wall (in cm or mm) None 17. Window 1: What is the window frame material? None 18. Window 1: Are there any external obstructions near this window? (e.g. balcony, awning, A/C unit, bars — describe or write “None”) 19. Window 1: For high-rise buildings, where does the high-rise section begin relative to this window? From ground floor From a middle floor N/A (not a high-rise) None 20. Window 2: What is the window size? (Width × Height in cm or mm) 21. Window 2: Distance A — top of window frame to ceiling (in cm or mm) None 22. Window 2: Distance B — floor to bottom of window sill (in cm or mm) None 23. Window 2: Distance C — left side of window frame to nearest wall (in cm or mm) None 24. Window 2: Distance D — right side of window frame to nearest wall (in cm or mm) 25. Window 2: What is the window frame material? Wood Iron / Steel Aluminum PVC / Vinyl Other Don't know None 26. Window 2: Are there any external obstructions near this window? (e.g. balcony, awning, A/C unit, bars — describe or write "None") None 27. Window 2: For high-rise buildings, where does the high-rise section begin relative to this window? None 28. Photos / Additional Information None 1 out of 1 Name Email Country Previous Start Survey Next Time's up
