customer survey


First Name [required] New Construction   Yes     No
Last Name [required] Remodeling   Yes     No
Home Phone Budget
Work Phone Schedule
Mobile Phone Year House Built
Fax Years Lived in House
Email [required]    
How would you describe the style of your house?
How were you referred to us? Have you seen any of our ads?   Yes     No
Are you working with a designer?   Yes     No Worked with this designer before?   Yes     No
Design Professional Designer Contact Number
Do you have a Contractor?   Yes     No Worked with this contractor before?   Yes     No
Contractor Name Contractor Contact Number

Design Questions

What is the overall scope of the project? [required]

What is it about your current kitchen that works for you in terms of aesthetic?

Wwhat is it about your current kitchen that does not work?

Please describe your specific needs:

Can you describe the style you are looking for?

Do you have any photos of kitchens or design elements that you like?

How many people are in your family (include ages of children)?

# of people working together in the kitchen? Do you want children to assist?   Yes     No
Are you right or left-handed? Your spouse/partner
How tall are you? Your spouse/partner
Do you want an eat-in kitchen?   Yes     No If you want an eat-in kitchen - for how many
Built-in top or separate table Eating/Dining Habits
Do you entertain frequently?   Yes     No When entertaining, for how many

Appliances

Have you done any looking and/or
pricing of appliances?		  Yes    No If you have been looking, where?
Check which appliances you are interested in below (please note desired finish/brand if known):
Refrigerator/Freezer
Range
Dishwasher
Ovens
Cooktop
Ventilation
Warming Drawers
Microwave
Ice-Maker
Coffee Maker
Toaster/Toaster Oven
Blender
Food Processor
Wine Storage
Mixer
Other

Plumbing Fixtures & Fittings

What type of plumbing fixtures, fittings and accessories are you interested in? (please note desired finish/brand if known):
Sink
Hand-Spray
Faucet
Disposer
Soap Dispenser
Other

Cabinetry

Door Style
Hardware
Accessories
   

Countertops

Material Color/Tone

Miscellaneous Details

Floor Finish Celiing Height
Wall Finish Windows
Lighting    

Notes & Comments

Mechanical Notes
Job Site Access
Molding and Trim
Additional Comments