Name: 
Address: 
City: 
State:      Zip:   
Home Phone with area code: 
Work Phone with area code: 
Cell Phone with area code: 
Fax with area code: 
Email: 
Jobsite is at the address above:     or it's      
Located at: 
City: 
State:      Zip:   
  HELP US OUT:  How did you find our website? Please choose... Referred by a Creative Kitchens designer Alta Vista Search Dogpile Search Excite Search Google Search Lycos Search Metacrawler Search MSN Search Other Seach Engine Yahoo Search A friend told me about it Other - I'll comment below By Accident
If our designer referred you here, let us know which one: Pick Name Dean B. Ed P. Karen M. Kris N. Larry M. Laura K. Laura R. Rich B.
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About how long will you live in the home you are renovating/building?  Please Select an Answer 1 to 5 Years 6 to 10 Years 11 to 20 Years 20+ Years
When was the house built? 
How old is the current kitchen? 
When would you like to begin your project? 
When would you like the project completed? 
If you are building, is the kitchen included in the contract?  Select No Yes
Do you have a budget for this project?  Select No Yes
Budget Amount:  $
Who will share in the decision making process? 
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Household & Lifestyle 
Number and approximate ages of household members?
Adults:   Ages: 
Teens:    Ages: 
Young Children:    Ages: 
Infants: 
Are you planning to enlarge your family while living in this home?  Select No Yes

Where do you currently eat meals on a regular basis?
Kitchen: 
Dining Room: 
Other: 

Where would you like to have your meals after you renovate/build?
Kitchen: 
Dining Room: 
Other: 

Do you require a kitchen table in the kitchen or are you willing to explore options?
Please Select A kitchen table is required A kitchen table is preferred but I'm open to other ideas A kitchen table is not necessary
Approximate size of table: 

What other activities will take place in your new kitchen?
Computer Center        Laundry        Homework        Watching TV/Movies
Paying Bills        Sewing        Wet Bar        Other:

Will you entertain frequently?  Select No Yes
If yes, what is your entertainment style?  Select Formal Informal
Do you usually have large or small gatherings?  Select Large Small
Do guests help you in the kitchen when you entertain?  Select No Yes
Do you hire caterers to work in the home when you entertain?  Select No Yes

How do you usually shop?
For the week       Buy in bulk and freeze       Buy for each meal
Buy non-perishable items in bulk

If you buy in bulk, do you require storage in the kitchen for all/most of the items?
Select No Yes

What type of specialized storage is required? 
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Cooking Style
Who is the primary cook? 
Is the primary cook left  or right  handed?   Left:      Right:
How tall is the primary cook? 

What are the primary cook's cooking style? 
Gourmet Meals       Family Meals       Quick & Simple Meals
Takeout       Baking

Do you engage in any specialty cooking?  Tell us a little about it:


What does the primary cook prefer?  Please select an answer about others in the kitchen No one else in the kitchen while preparing meals A helper in the kitchen while preparing meals Visiting with family and friends during meal preparation

Does the primary cook have any physical limitations? 
Please describe:
 

Who's is the secondary cook? 
Do the primary & secondary cooks prepare meals together?  Select No Yes
Is the secondary cook left  or right  handed?   Left:      Right:
How tall is the secondary cook? 

What are the secondary cooks responsibilities?
Preparing side dishes       Assist in main course       Cleanup

Does the secondary cook have any physical limitations? 
Please describe:

Will children be assisting with meal preparation?  Select No Yes
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Design and Style
What colors are you considering for your new kitchen?

What type of style would you like your new kitchen to reflect?
Please select a choice of style Old World Charm Contemporary Casual Living Country Traditional Professional Other - Let's discuss what I have in mind

Have you created a sketch or collected pictures and ideas that you would like to use in your new kitchen?  Select No Yes

If a design could be greatly improved, would you be willing to make structural changes? (relocate doors, windows, etc.)  Select I would not want to make structural changes I would consider making structural changes

What do you like about your current kitchen?

Do you require a recycling center in your kitchen?  Select No Yes
If Yes, which items do you need to sort? 

Will you be keeping your existing appliances?
Dishwasher: Select Existing New N/A
Refrigerator:  Select Existing New N/A
Oven/Range:  Select Existing New N/A
Cook top:  Select Existing New N/A
Microwave:  Select Existing New N/A
Hood:  Select Existing New N/A
Warming Drawer:  Select Existing New N/A
Trash Compactor:  Select Existing New N/A
Other: 

COMMENTS:                                  
(Write as much as you like. If you already have a builder and/or architect, let us know).                                          
 

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