Client Requirement

Entry Form

D11 Technology | info@d11.ae | www.d11.ae

Client

Project

Features

Diagnostic

Site

Priority

Review

👤

Client Information

Your contact and project details

Client Name

Company Name

Project Name

Location

Contact Person

Mobile Number

Email Address

Date

Step 1 of 7

🏗️

Project Type

Select the type that best describes your project

🏡Villa

🏢Apartment

💼Office

🛍️Shop

🏭Warehouse

🏨Hotel

🍽️Restaurant

🎓School

🏥Hospital

⚙️Factory

➕Other

Specify Type

Step 2 of 7

⚡

Features Required

Toggle on features; fill qty and notes as needed

🔍

FeatureRequiredQty / AreaNotes

Step 3 of 7

🔧

System Diagnostic

Log current problems, upgrade needs, suggestions and resolutions

System / Component	Current Problem	Upgrade?	Suggestion	Resolution

Add as many systems as needed

Step 4 of 7

🏛️

Site Information

Property details and existing infrastructure

Number of Floors

Number of Rooms

Parking Area

Construction Status

Expected Completion Date

Existing Infrastructure

Internet

CCTV

Access Control

Step 5 of 7

🎯

Client Priority

Select all priorities that apply

💰 Budget Friendly

✅ Standard Solution

👑 Premium Solution

🤖 Smart Automation

🔐 High Security

🚀 Future Expansion

Additional Requirements

Step 6 of 7

📋

Review & Approval

Confirm details, export PDF, print or submit

✍️ Approval

Sales Engineer Name

Approval Date

⚠️ By submitting, the client confirms all information is accurate and authorizes Ehome to proceed with a solution proposal.

Step 7 of 7

✓

Form Submitted!

Your requirement form has been submitted successfully.
Our D11 Technology team will contact you within 24–48 hours.

REF-EHOME-XXXXXX