space
space
space
space
Kitchen & Bath Design Survey

 
(If you would rather fax or mail this form, download it in PDF format to print)
     
Name: 
Home Phone:
Address:
Work Phone:
Job Site Address:
Mobile Phone:
Type of Remodel:
Kitchen Remodel Bathroom Remodel
How did you hear about us?
Other (specify):
 
How much are you willing to invest?
 Will cabinets be needed, and when?:   Yes No 
Are the cabinets to be delivered to the job site?: Yes No   
 

Have you been to
a showroom yet?:
Yes No    

When?: Where?:
Number of people in your household? (Specify Adults and Children):
Number of Pets:
Handed?: Right Left How tall are you?:
Do you enjoy cooking?
Yes No     		Baking?
Yes No 		 Specialty Cooking?
 Yes No 		 Canning?
 Yes No 		 More than one cook?
 Yes No 
How often do you entertain?
 
Frequently Occasionally Never Formally Informally
Type of eating area desired:
 Table size:
Number normally served at one time:  
How often do you shop for food?:
Do you purchase any products in bulk?:
Where do you presently store your food and canned goods?:
Where do you presently store your tall cleaning and ironing equipment?:
 
What type of specialized storage do you desire? (choose below):
Kitchen   Bathroom
Pantry Linen Storage Pantry
Appliance Garage Rollout Shelves Cosmetic Organizers
Cutlery Dividers Lazy Susan Vanity Organizers
Tray Storage Spice Storage Laundry Hamper
Cookbook Storage Bread Drawer Mirror(s) How many?
Extra Breadboard Tilt Out Trays Safety Aids
Wine Rack Knick Knack Shelves Niches
Wine Glass Holder Towel Rack Shower Shelves
File Drawers Pull Out Chopping Block Towel Bars
Open Corner Shelves Other Kitchen(specify above) Other Bathroom (specify above)
What other activities will take place in your kitchen area? (choose below):
Eating Wet Bar Planning Desk Sewing
Study Area Laundry Cake Decorating Hobbies
Growing Plants Other (specify above)    
 
Can the location of doors and windows be changed it necessary?:
 
Appliance Information:
Type
Make
Model
Measurements
Range
Cooktop
Wall Oven
Microwave
Hood
Dishwasher
Trash Compactor
Refrigerator
Sink
Other
 
What are you dissatisfied with in your present kitchen or bath? 
 
 
What ideas do you have for your new kitchen or bath?
Do you have any sketches or pictures of ideas for your kitchen or bath?: Yes No 
Has anyone else done a kitchen or bath plan for you? Yes No 
Does your spouse entertain or cook in the kitchen? Yes No 
What does your spouse think of the new kitchen or bath?
           
  imgvar    
Please type the letters shown above
(All lowercase please)		    
 


 
~ Home ~ Contact ~ Blog ~ Cost VS. Value Report
PHP Warning: PHP Startup: Unable to load dynamic library './php_curl.dll' - The specified module could not be found. in Unknown on line 0