RocketEV Intake Form

RocketEV Home Installation Request Form
Electrify Your Home with RocketEV!

Here’s how it works:

1. Intake Form: We’ll collect some basic information to get started.

2. Virtual Quote Form: You’ll complete a short online form to provide more details.

3. Electrician Review: A licensed electrician will review your information and any photos provided to assess your needs.

4. Quote: A detailed quote will be emailed to you. We will require an e-signature approval to proceed.

5. Schedule Your Installation: Once everything’s confirmed, a RocketEV agent will contact you to find a convenient time to install your charger. An invoice will be emailed to you upon completion.

Please note: A brief in-person consultation might be necessary for complex installations. Also, if your electrical panel is close to its capacity, we may ask you to get a “Peak Hourly Consumption” report from your utility company (this usually takes a few days). This is required in order to obtain a permit.

Please indicate whether you are a client OR a salesperson completing the form on behalf of the client.

RocketEV Home Installation Request Form
Full Name

First NameLast Name
Phone

Area CodePhone Number
E-mail Address

Confirmation Email
Please select the region that best applies to the installation site
Installation Address

Street Address

Street Address Line 2

CityProvince

Postal CodeCountry
What type of home do you live in?
Please select the service you are interested in
Please list the Dealership where purchased (if applicable).
Salesperson's Full Name (if applicable)

First NameLast Name
Salesperson's Email (if applicable)
example@dealership.com
Should be Empty: