FAMILY AND LIFESTYLE INFORMATION

First Name:	*
Last Name:	*
Street Address:	*
Address (cont.):
City:	*
State/Province:	*
Zip/Postal Code:	*
Home Phone:
Work Phone:
E-mail:	*
Preferred Method of Contact:	Home Phone Work Phone Email

Will you be remodeling or building a new home?

Remodel Existing Kitchen
New Construction

How long do you plan on living in the home you are remodeling/building?

Less than 10 years
More than 10 years
I don't know

How many family members??

1
2
3
4
5
6+

What room will your family sit down to eat in after you remodel/build?

Kitchen
Dining Room
Other

What other activities will take place in your new kitchen?

Watching TV
Computer Work
Homework
Organizing/Paying Bills
Other

How often do you purchase groceries?

For each meal
For the week
Purchase non-perishable items in bulk
Purchase items in bulk and freeze

COOKING STYLE INFORMATION

Who is the primary cook?

Is the primary cook:

Left Handed
Right Handed

How tall is the primary cook?

What is the primary cook's cooking style?

Bringing meals home
Quick and simple meals
Family meals
Baking
Gourmet meals

What does the primary cook prefer?

No one else in the kitchen while preparing meals.
A helper in the kitchen when preparing meals.
Family or friends visiting during meal preparation.
Doesn't matter.

Is there a secondary cook?

Yes
No

If so, who is the secondary cook?

Is the secondary cook:

Left Handed
Right Handed

How tall is the secondary cook?

Do the secondary and primary cook prepare meals together?

Yes
No
Sometimes

KITCHEN DESIGN INFORMATION

Have you created a scrapbook of notes, photos, and ideas that you would like to use in your new kitchen?

Yes
No

What do you like about your current kitchen?

What do you dislike about your current kitchen?

What appliances do you plan on using in your new kitchen?

Refrigerators	Ranges
Refrigerator - Freezer on top	Range - Free Standing
Refrigerator - Freezer on bottom	Range - Slide In
Refrigerator - Side by Side	Range - Drop In
Refrigerator Drawers	Range - Commercial
Dishwashers	Cooktops
Dishwasher - Under counter	Cooktop - Electric
Dishwasher Drawers	Cooktop - Gas
	Cooktop - Downdraft
Wall Ovens	Cooktop - Commercial
Wall Oven - Single
Wall Oven - Double	Hoods
Wall Oven - Under Countertop	Hood - Non Vented
	Hood - Vented
Microwaves	Hood - Microwave
Microwave - in Oven Cabinet
Microwave - Built in cabinet	Warming Drawers
Microwave - Countertop	Warming Drawer
Other
Wine Refrigerator
Trash Compactor

CABINETRY AND COUNTERTOP INFORMATION

What species of wood do you prefer?

Alder
Cherry
Maple
Oak
Pine
Don't know

What type of finish would you prefer?

Natural
Stained
Stained with Glaze
Painted Finish
Painted with Glaze
Don't Know

What type of Door style do you prefer?

Flat (Contemporary)
Raised Panel
Recessed Panel
Don't know

Do you prefer arched panels on the wall cabinet doors?

Yes
No

What options would you like to use in your new kitchen?

Lazy susans in the base corners	Roll-out shelves
Pantry Cabinet	Tray Dividers
Cutlery Divider	Pull out Trash
Pot and Pan Drawers	Tilt out Sink Front
Appliance Panels	Under Cabinet Lighting
Bread Drawer	Spice Rack

What type of Countertop material would you like to use in your new kitchen?

Granite
Man-made Granite (Silestone, Ceaserstone etc.)
Solid Surface (Corian, Gibralter etc.)
Butcherblock
Stainless Steel
Plastic Laminated with Wood Edge
Plastic Laminated - Self Edge
Don't know

When would you like your project completed?

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