1. Number of family members: ___

2. Number and approximate ages of family members:

__ infants __ young children __ teens __ 20 to 30 yrs __ 31 to 40 yrs __ 41 to 50 yrs __ 51 to 60 yrs __ 61 to 70 yrs __ 70+ 

3. If your family has young children, will they be using the kitchen frequently? __ Yes __ No

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

__ 1 to 5 yrs __ 6 to 10 yrs __ 11 to 20 yrs __20+

5. Where does your family eat its meals?

__ Kitchen __ Dining Room __ Other:______________________

6. Where will your family eat after you remodel/build?

__ Kitchen __ Dining Room __ Other:_____________________

7. Do you require a kitchen table or would you be willing to explore other options if a design could be improved?

__ A kitchen table is required __ A kitchen table is preferred but open to other options __ A kitchen table is not necessary

8. What other activities will take place in your new kitchen?

__ Laundry __ Homework __ Watching TV __ Paying Bills __ Sewing __ Computer Center __ Other:___________________ __ Other:____________

9. After your remodel/build will you entertain frequently? __ Yes __ No

If Yes... What is your entertainment style? __ formal __ informal

Do you have __ large or __ small gatherings?

Do your guests help you in the kitchen when you entertain? __ Yes __ No

10. How do you shop?

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

If you buy in bulk, do you require storage in the kitchen for all or most of these items? __ Yes __ No

1. Who is the primary cook? _______________________

2. Is the primary cook __ left handed or __ right handed?

3. How tall is the primary cook? _______

4. What is the primary cook's cooking style?

__ Gourmet Meals __ Family Meals __ Quick & Simple Meals __ Bringing Meals Home __ Baking

5. 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.

6. Does the primary cook have any physical limitations? __ Yes __ No

7. Who is the secondary cook? _____________________

8. Do the secondary and primary cook prepare meals together? __ Yes __ No

9. Is the secondary cook __ left handed or __ right handed?

10. How tall is the secondary cook? ________

11. What are the secondary cook's responsibilities?

__ Preparing side dishes __ Clean up __ Assist in preparing main course

12. Does the secondary cook have any physical limitations? ___________________________

1. What are your color preferences for your new kitchen? _________________________________________________

2. Are there colors you would not want in your new kitchen? ________________________________________

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

__ Yes __ No

4. If a design could be greatly improved, would you be willing to make structural changes? (i.e. moving windows, doors, and walls)?

__ Absolutely not __ I would consider it

5. What do you like about your current kitchen?

_________________________________________________ _________________________________________________

6. What do you dislike about your current kitchen?

__________________________________________________ __________________________________________________

7. Do you require a recycling center in your kitchen?

__ Yes __ No

If Yes... How many items do you need to sort? ___

8. Will you be keeping your existing appliances?

Dishwasher: __ existing __ new

Refrigerator: __ existing __ new

Oven/Range: __ existing __ new

Other:

9. What is your style preference for your new kitchen?

__contemporary __formal __country __traditional

10. Are there any special storage needs? (e.g. tall mixer, large amount of spices, kosher kitchen)

__________________________________________________

1. When would you like to begin your project? ________________________________________________________

2. When would you like your project completed? ______________________________________________________

3. If you are building, is the kitchen in your contract? __ Yes __ No

4. Do you have a budget for this project? __ Yes: $ ________________ __ No

1. Name: __________________________________________

2. Address: ________________________________________

3. City: _______________________ State: ___ Zip: _______

4. Home Phone: ___________________________

5. Work Phone: ___________________________

6. Fax: __________________________________

7. New Home Address: ______________________________

9. City: _______________________ State: ___ Zip: _______

9. Builder Name (if applicable): _______________________

10. Contact Name: _________________________________

11. Phone: _______________________________

12. Fax: _________________________________

13. Architect Name (if applicable): ____________________

14. Contact Name: __________________________________

15. Phone: _______________________________

16. Fax: _________________________________

17. Interior Designer Name (if applicable): ____________

18. Contact Name: _________________________________

19. Phone: _______________________________

20. Fax: _________________________________