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
__ Preferred but open to other options
__ Not necessary
8. What other activities will take place in your new kitchen?
__ Laundry __ Homework __ Watching TV
__ Paying Bills __ Sewing __ Computer Center
__ 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
__ 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
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 __ Other ________________________
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? __________ __ left handed or __ right handed?
8. How tall is the secondary cook? ________
9. Do the secondary and primary cook prepare meals together? __ Yes __ No
10. What are the secondary cook's responsibilities?
__ Preparing side dishes __ Clean up
__ Assist in preparing main course __
11. 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) __ 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
9. What is your style preference for your new kitchen?
__ contemporary __ formal
__ country __ traditional
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: ___________________________________
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: ___________________________________