Client Intake Form - Green Terra Alliance

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Client Intake Form

Welcome to our client intake form, please provide your information to enable us customize your protocol.

Name of Individual /Business

Email

Phone Number

Please Select Following

Farm Greenhouse Lawn

Do you have an ESG policy you can share?

Yes No

If Farm and Greenhouses, What Crops? If Garden/lawn/Forest what plant specie?

If Farm and Greenhouses, What Crops? If Garden/lawn/Forest what plant specie?

If Farm and Greenhouses, What Crops? If Garden/lawn/Forest what plant specie?

Size of your Farm / Greenhouse / Lawn (Sq. Ft.)

Size of your Farm / Greenhouse / Lawn (Sq. Ft.)

Size of your Farm / Greenhouse / Lawn (Sq. Ft.)

Can you provide the Latitude/Longitude values for the corners representing the area (s) where the lawns/farms/Gardens is located?

Can you provide the Latitude/Longitude values for the corners representing the area (s) where the lawns/farms/Gardens is located?

Can you provide the Latitude/Longitude values for the corners representing the area (s) where the lawns/farms/Gardens is located?

What do you do with the grass clippings?

Discard Feed To The Animals

What is the current Frequency of cutting/clipping grasses?

What is the current frequency of irrigation? (Hours)

What is the current frequency of irrigation? (Hours)

What is the current frequency of irrigation? (Hours)

What is the current water consumption?

What is the current water consumption?

What is the estimated average water consumption?

What is the estimated average water consumption?

Total area

Total area

Flow rate of irrigation system (Liters/Minute or Hour)

Flow rate of irrigation system (Liters/Minute or Hour)

Do you currently have a flow meter installed in your fertigation system?

Do you currently have a flow meter installed in your fertigation system?

Can you provide the specification (including electrical specifications) for all your fertigation equipment

Can you provide the specification (including electrical specifications) for all your fertigation equipment

How do you currently apply your fertilizer?

Via Irrigation (fertigation) Broadcasting Both

What is the current frequency for:

What is the current frequency for:

Liquid fertilizer application (Per week)

Liquid fertilizer application (Per week)

Dry fertilizer application (per week)

Dry fertilizer application (per week)

What is the current application rates for:

What is the current application rates for:

Liquid fertilizer application (L/sqm)

Liquid fertilizer application (L/sqm)

Dry fertilizer application (kg/sqm)

Dry fertilizer application (kg/sqm)

How much water do you use per week? (In Liters)

How much water do you use per week? (In Liters)

Do you have the ability to spread granular fertiliser accurately at a rate of 5kg/SQM?

Do you have the ability to spread granular fertiliser accurately at a rate of 5kg/SQM?

Do you have a recent soil test report and Tissue sample reports that you can share?

Yes No

Please upload a picture or pdf file

What is the brand name of the liquid and dry fertilizer you have used in the past?

Do you have the ability to dilute a water-soluble dry fertilizer on site? Using our protocol, we aim to reduce your current water consumption by 35%.

Yes No

Can you share you water bill for three months in the hottest months in the summer and three months in the coolest months in the winter?

Can you share you water bill for three months in the hottest months in the summer and three months in the coolest months in the winter?

What Insects, pests and fungi causes nuisance?

How much do you current spend on fertilizer and other grass protection chemicals (Insecticide, pesticides and fungicides) per month? If Farm, per season?

How much fertilizer do you use per week? (In Kg.)

How much fertilizer do you use per week? (In Kg.)

What is your current cost of fertilizers? (In AED)

Do you have a team that applies your fertilizers?

Please upload a current picture of your lawn/grasses/trees or bushes

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