Please note that all fields followed by an asterisk must be filled in.
Please review my Questionnaire and contact me for a Consultation*
Please review my Questionnaire and contact me for a Consultation*
First Name*
First Name*
Last Name*
Last Name*
E-mail Address*
E-mail Address*
Street Address*
Street Address*
City*
City*
State/Prov*
State/Prov*
Zip/Postal Code*
Zip/Postal Code*
Country*
Country*
Country
United States
Canada
----------------
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
British Virgin Islands
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and McDonald Islands
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Ivory Coast
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribadi
North Korea
South Korea
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Federated States of Micronesia
Moldova
Monaco
Mongolia
Monserrat
Morocco
Montenegro
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Island
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russia
Rwanda
S. Georgia and S. Sandwich Isls.
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and The Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
St. Helena
St. Pierre and Miquelon
Sudan
Suriname
Svalbard and Jan Mayen Islands
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
U.S. Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
US VIrgin Islands
Wallis and Futuna Islands
Western Sahara
Yemen
Yugoslavia (former)
Zaire
Zambia
Zimbabwe
Home Phone*
Home Phone*
Business Phone
Fax
Are you the homeowner or a trade professional?*
Are you the homeowner or a trade professional?*
---Select--- \nA. Homeowner
B. Builder/Developer
C. Architect
D. Interior Designer
E. Independent Consultant
What rooms are included in this project?*
What rooms are included in this project?*
If Other, What rooms?
FAMILY and LIFESTYLE
Number of family members?*
Number of family members?*
Approximate ages.
If your family has young children will they be using the kitchen frquently?
Have you been living in your home for less than a year?
How long do you plan on living in the home you are remodeling/building?*
How long do you plan on living in the home you are remodeling/building?*
---Select--- \nA. 1 to 5 yrs
B. 6 to 10 yrs
C. 11 to 20 yrs
D. 20+ yrs
What do you dislike most about your present kitchen?
What works particularly well in you present kitchen?
What improvemnts are you looking for in a new kitchen?
If Other, Please explain
Is there anything specific you would like to include in your kitchen? List some details of the new kitchen that are important to you.
Where does your family currently eat its meals?
Where will your family eat its meals after you remodel/build??
Do you require a kitchen table or would you be willing to explore other options if a design could be approved?
After you remodel/build will you entertain frequently?
Please check the statement that best describes the way you feel.*
Please check the statement that best describes the way you feel.*
Do you entertain for Holidays? How?
---Select--- \nA. Informal
B. Formal
C. Formal and Informal
Do you entertain Friends? How?
---Select--- \nA. Informal
B. Formal
C. Formal and Informal
Do you entertain for Business
---Select--- \nA. Informal
B. Formal
C. Formal and Informal
What secondary activities would you like to take place in your kitchen?*
What secondary activities would you like to take place in your kitchen?*
How ofter do you shop?*
How ofter do you shop?*
If you buy in bulk, do you require storage in the kitchen for all or most of these items?
COOKING STYLE
Who is the primary cook?*
Who is the primary cook?*
Is this person right-handed or left-handed?
How tall is this person?
What is the primary cook's cooking style?
What does the primary cook prefer?
Does the primary cook have any physical limitations?
Who is the secondary cook?
Is this person right-handed or left-handed?
How tall is this person?
Does the primary cook have any physical limitations?
Does the primary and the secondary cook prepare meals together?
What are the secondary cook's responsibilities?
DETAIL QUESTIONS
What small appliances do you use in your kitchen?
Which items need specialized storage?
Which items do you recycle?
Where do you sort?
Where would you like to store the following items? See selection in CheckBoxes below each item.
Baking equipment
Paper products
Cleaning supplies
Linens
Glassware
Leftover containers
Fruits and Vegetables (non-refrigerated)
Laundry | Iron
Spices
Pet foods
Wrapping material (i.e. foil, wax paper, plastic wrap, baggies)
Recylce containers
Specialty cooking items (i.e. wok, blender)
Canned goods
Boxed goods
Dishes
Pots and Pans
Serving trays
Please check if you desire any of the following:*
Please check if you desire any of the following:*
If other, please explain
DESIGN AND STYLE OPTIONS
If a design could be greatly improved, would you be willing to make structural changes? (i.e. moving, windows, doors, and walls)*
If a design could be greatly improved, would you be willing to make structural changes? (i.e. moving, windows, doors, and walls)*
If you are changing out your cabinets, what type of facing material do you prefer?
If you selected wood what species or type?
What cabinet door styles do you prefer?
If you are changing out your countertops, which do you prefer?
If Other, please explain
What flooring materials do you prefer?
If Other, please explain
What type of feeling would you like your new kitchen space to have?
What colors do you like?
What colors do you particularly dislike?
What colors are you considering for your new kitchen?
Ther design needs or ideas:
TIME AND BUDGET
When would you like your project to begin?
---Select--- \nA. Immediately
B. Within 30 days
C. Within 3 months
D. 3-6 months
e. New Construction
When would you like your project completed?
---Select--- \nA. Within 30 days
B. Within 3 months
C. 3-6 months
D. 6 months-1 yr
If new construction, ETA?
If you are building, is the kitchen in your contact?
What is your budget or allowance for cabinetry?
---Select--- \nA. Less than $5,000
B. Between $5000 and $10,000
C. Between $10,000 and $15,000
D. Between $15,000 and $20,000
E. Between $20,000 and $25,000
F. Between $25,000 and $30,000
G. Between $30,000 and $40,000
H. Bewteen $40,000 and $50,000
I. Over $50,000
Do you have a kitchen layout with basic measurements?
Have you received estimates for kitchen cabinets from local retailers?
Any other Questions or Comments?