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 

  
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
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?  Yes No 

  
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)? 

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 

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

1. Name:  

2. Address:

3. City:   State: Zip:

4. Home Phone:

5. Work Phone:

6. Fax:

7. Email Address: *required

8. New Home Address:

9. City: State:  Zip:

10. Builder Name (if applicable):

11. Contact Name:

12. Phone:

13. Fax:

14. Architect Name (if applicable):

15. Contact Name:

16. Phone:

17. Fax:

18. Interior Designer Name (if applicable):

19. Contact Name:

20. Phone:

21. Fax: