Nissan Intake Form

Home Charger Installation for Nissan Vehicles

Provided by RocketEV Charging Solutions
RocketEV is proud to be Nissan Canada's EV Home Charger Installation partner.

The process for electrifying your home with RocketEV is simple:
1. Request a FREE consultation by submitting this form
2. A RocketEV agent will aim to contact you within 2 business days to book a consultation.
3. A licensed electrician will conduct the consultation and provide a quote
4. Based on your approval of the quote, an installation will be booked when it is mutually convenient.

Home EV Charger Installation Form
Full Name

First NameLast Name
Phone

Area CodePhone Number
E-mail Address
Address

Street Address

Street Address Line 2

CityProvince

Postal CodeCountry
What is your preferred method of contact?
What is your preferred timeline for an initial site consultation? Please be advised that due to high demand we cannot guarantee your selected time-slot.

Other
What type of home do you live in?
Is there an electrical outlet in your garage?
What voltage is the electrical outlet in your garage?
Where is the electrical panel located in the home?

Other
Approximately how far in feet is the electrical panel located from the garage? – Distance in ft.

Other
When do you expect to receive your vehicle?
Are there any specific instructions that our install team should be aware of?
Please list the Dealership where purchased.
Please list the Dealership Sales Consultant if applicable.
Please list the vehicle type purchased if applicable.
Ex: Audi Etron / Tesla 3
Upload Supporting Images.

Add Photo
Helpful photos would be: panel, charger location, wire path from panel to charger, etc. Cancelof
Should be Empty:

Home Charger Installation for Nissan Vehicles