*Denotes required fields
Name:*
Address:*
City:*
State:*
New York
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip:*
Phone:*
Cell:
Email:*
Basics:
How many family members will be using the newly remodeled
kitchen?
How often is the kitchen used to prepare meals?
Select One
Once a day
Twice a day
Three times a day
Not that often
Are family meals important?
Select One
YES
NO
If yes, will the entire family eat at the same time?
Select One
YES
NO
Do you prefer a formal or informal setting?
Select One
Formal
Informal
Is there a separate dining room
Select One
YES
NO
How often is the dining room used over the kitchen for meals?
How often do you entertain guests?
Are you thinking of using a kitchen table or an island counter
for meals in the kitchen?
Select One
Kitchen Table
Island Counter
If a kitchen table will be used, what shape do you prefer?
Select One
No preference
Round
Oval
Square
Rectangle
Will a table be purchased for the new kitchen or will you use
and existing one?
Select One
New
Existing
Who does most of the cooking?
How tall are the main cooks in your family?
Are their any special needs that must be considered in the
design?
Select One
Left handed
Physically challenged
Kosher
Other
If Other from above:
How often do you grocery shop?
Select One
Monthly
Bi-weekly
Weekly
Twice a week
Daily
Are bulk food purchases part of your routine?
Select One
YES
NO
How/where do you store your groceries now?
Select One
In the kitchen
In the basement
Other
If Other from above:
How/where do you store the broom, mop, vacuum cleaner, ironing
board?
Is recycling a part of your daily life?
Select One
YES
NO
If so, do you want a recycling area incorporated into your
kitchen?
Select One
YES
NO
Please include:
Plastic
Glass
Newspaper
Other
Multiple items may be selected.
What type of lighting do you prefer?
Florescent
Can light
Incandescent
Under the counter lighting
Multiple items may be selected.
Are there other rooms besides your kitchen that will be
involved in the project?
Select One
YES
NO
Explain:
Which of those rooms will need to be configured for cabinetry
of some kind?
Are you willing to change the location of doors and/or windows
if necessary?
Select One
YES
NO
Will you be considering new appliances for the kitchen?
Select One
YES
NO
If yes, will it be at the time of remodel or at a later date?
Select One
At Remodel
Later Date
What items will you need space for in your newly remodeled
kitchen?
Coffee maker
Toaster
Food processor
Blender
Mixer
Wok
Smoothie Maker
Juicer
Food Dehydrator
Microwave
Knife Block
Spice Rack
Canisters
TV
Radio
Other
Multiple items may be selected.
You’re Preferences:
Please tell us what you like about your present kitchen.
Please tell us what you do not like about your present kitchen.
Please give us your thoughts, ideas, magazine clippings,
pictures, sketches, of anything that you would like to see
incorporated into your kitchen.
Are any of the following activities important to you?
Cooking
Canning
Baking
Grilling
Gourmet cuisine
Seasonal freezing
Other
Multiple items may be selected.
What level of entertaining will the kitchen be a part of?
Select One
Formal
Informal
None
Please tell us what features you would like us to incorporate
into your kitchen?
Appliance garage
Appliance panels
Bookcase
Bread box
China cabinet
Cutlery tray
Cutting board
Decorative moldings
Desk area
Ironing board base
Lazy Susan
Low Mixing Center
Microwave shelf
Open shelving
Pantry
Recycling center
File drawers
Sliding trays
Spice storage
Tile-out sink tray
Trash hamper
Tray dividers
Utility cabinet
Vegetable storage
Wine storage
Computer area
Multiple items may be selected.
What other activities take place in your kitchen?
Computer
homework
TV
Music
Sewing
Scrapbooking
Laundry
Painting/Drawing
Other
Multiple items may be selected.
Your wood preference:
Your partners wood preference:
Your preferred color:
Your partners preferred color:
Have you worked with other companies on kitchen designs?
Select One
YES
NO
Changes you are thinking of:
Cabinets:
Material
Shape
Finish
Multiple items may be selected.
Countertops:
Laminate
Solid Surface
Backsplash
Color
Multiple items may be selected.
Soffit:
Remove
Create
Alter
Multiple items may be selected.
Electrical:
Add outlets
Move outlets
Change wattage
Change amperage
Multiple items may be selected.
Lighting:
Move
Change
Add
Remove
Multiple items may be selected.
Lighting Focus:
Ceiling
Sink
Table
Under Cabinets
In Cabinets
Recessed
Multiple items may be selected.
Plumbing:
Change
Move
Leave as is
Multiple items may be selected.
Flooring:
Select One
Change
Use existing
Thinking of using:
Hardwood
Cork
Bamboo
Laminate/Pergo
Ceramic
Resilient
Carpet
Multiple items may be selected.
Wall finishes:
Painting
Wall Paper
Faux Design
Tile
Wainscoating
Combination
Multiple items may be selected.
Ceiling:
Select One
Paint
Re-Install
Window treatment:
Select One
Existing
New
Other:
Budget:
What is the time frame that you would like to see this project
completed?
Select One
0-6 Months
6-12 Months
12 - 24 Months
What is your budgeted investment for this project?
Select One
$3-5,000
$5-8,000
$8-12,000
$12-15,000
$15-20,000
$20-30,000
$30-40,000
$40,000 - above
What do you consider to be the main reason for remodeling your
kitchen?
How do you plan on paying your new kitchen?
Select One
Cash
Home Equity Loan
Charge Card
Other Financing
If you finance, would you like us to include information from
our financing partners?
Select One
YES
NO
Please list any other information that may be useful in
designing your dream kitchen.
respects your privacy . Please don't hesitate to call us if
you have any questions.
