2. Number and approximate ages of family members:
Children Adults
Age___ Sex___ Age___ Sex___
Age___ Sex___ Age___ Sex___
Age___ Sex___ Age___ Sex___
Age___ Sex___ Age___ Sex___

3. 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+

4. Where does your family eat its meals?
__ Kitchen __ Dining Room
__ Other:________________

5. Where will your family eat after you remodel/build?
__ Kitchen __ Dining Room
__ Other:________________

6. 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
__ Preferred but open to other options
__ Not necessary

7. What other activities will take place in your new kitchen?
__ Laundry __ Homework __ Watching TV
__ Paying Bills __ Sewing __ Computer Center
__ Other:

8. 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?
__ large or __ small
Do your guests help you in the kitchen when you entertain?
__ Yes __ No

9. How do you shop?
__ For the week
__ For each meal
__ Buy non-perishable items in bulk
__ Buy in bulk and freeze
If you buy in bulk, do you require storage in the kitchen for all or
most of these items?
__ Yes __ No

Cooking Style:

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 __ Baking
__ Bringing Meals Home

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 What type?_________________________

7. Is there a secondary cook?
__ Yes __ No

8. If there is a secondary cook, which are they
__ left handed or __ right handed?

9. How tall is the secondary cook? ________

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

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?
__ Yes __ No What type?_________________________

Design and Style:

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)
__ Yes __ No

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
Microwave: __ existing __ new

9. What is your style preference for your new kitchen?
__ contemporary __ formal
__ country __ traditional

Time and Budget:

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

General Information:

1. Name:
2. Address:
3. City/ State/ Zip:
4. Home Phone:
5. Work Phone:
6. Fax:
7. New Home Address:
8. 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: