FAMILY
AND LIFESTYLE
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
__ 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?
______________________________________
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?
4. If a design could be greatly improved, would you be willing to make
structural changes? (i.e. moving, indows, 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?
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. 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: _________________________________
