Describe your service area and program rules. Makeform creates an application for household details, utility accounts, past-due amounts, documents, and preferred follow-up.
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Sample prompts for the builder
Choose an example, replace its program wording, and send it to the builder. Review every field before publishing.
Audience
Residents requesting help with an overdue electric account
Format
Application with shutoff triage and bill upload
Prompt size
277 chars
Example form structure
Application with shutoff triage and bill upload
Resident and service address
Household members and size
Provider, account, and amount due
Is shutoff scheduled?
Upload the current bill or notice
Suggested routing tags
Shutoff urgent
Documents missing
Ready for review
Ask for the service address, utility provider, account-name match, shutoff date, and exact amount due as separate fields. Caseworkers can triage urgent requests without searching a bill image.
Step 1
Apply
resident, household, account, and need
Step 2
Check
service area, bill, and required documents
Step 3
Review
caseworker follows program criteria
Step 4
Follow up
resident receives status or next steps
Why structured intake matters
An application separates shutoff details from household information and files, making requests easier to review consistently.
Required provider, account-holder, balance, due-date, and service-address fields reduce avoidable follow-up.
Show electric, gas, water, oil, or propane details only when the resident selects that service.
Route urgent shutoffs, missing documents, and review-ready applications into visible follow-up paths.
Adapt it to your program
Start with the closest pattern, then add your service area, utility types, document rules, and review language.
Capture the bill, arrears, due date, requested amount, and account-name match.
Collect disconnection status and date, then flag urgent follow-up.
Show conditional sections for only the utilities selected.
Gather household, heating source, vendor, quote, and priority details.
Application workflow
Turn your program guidance into a resident-friendly form, then connect each complete submission to the team handling follow-up.
Name your service area, utilities, documents, priorities, and recipient.
Make core fields required and explain each document request.
Preview utility choices, shutoff answers, uploads, and confirmations.
Publish the form and connect responses to your case workflow.
Online form vs email vs document
Program guidance explains what may be considered; a structured form captures the resident's account, need, documents, and contact preferences in one record.
Field guide
These six sections give program staff enough structured information to identify the household, understand the utility need, check documents, and follow up.
Applicant
Collect only needed identity and contact details, and let residents choose how staff may respond.
Household
Use repeatable member fields so staff can understand household size quickly.
Utility account
Separate utility, provider, account holder, and service address for each account.
Urgency
Ask about disconnection status, then show dates and restoration questions when relevant.
Documents
Explain each required file and show uploads only when relevant.
Confirmation
Let applicants review amounts, confirm accuracy, and understand that submission starts review.
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Open toolFAQ
Practical answers for charities and agencies creating an intake for residents with overdue utility bills.
It collects a resident's household, utility account, overdue balance, urgency, requested support, documents, and contact preferences. Submission starts staff review; it does not promise funding or a decision.
Include contact, service address, household size, utility, provider, account holder, account reference, balances, due or shutoff date, requested amount, uploads, follow-up method, and accuracy confirmation.
Yes. Start with utility checkboxes, then show provider, account, balance, date, and document fields for each selected service.
Ask whether service is active, scheduled for shutoff, or disconnected, then collect the date and notice. Route urgent responses through your established contact path.
Follow your program rules and request only necessary records. Explain their purpose and alternatives for residents who cannot upload. Keep key bill details in separate fields.
Yes. Use service area, utility, shutoff status, or program to organize follow-up and notify the responsible team.
Yes. Makeform provides unlimited free forms and responses, so you can generate, edit, publish, and collect applications without a response cap. The paid tier is only for removing the Makeform badge.
Use neutral language such as submit for review, explain next steps and contact methods, and avoid approval promises.
Turn utility-support requests into complete applications.
