Name *

First Name

Last Name

Home Phone

(###)

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Cell Phone

(###)

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Project type (please check all that apply)

new construction

furnishing/design/decor

remodel

paint selection

other

What is your total project investment (interior design, construction and materials)?

$10,000-$25,000

$25,000-$50,000

$50,000-$75,000

$75,000-$100,000

$100,000-$200,000

other

How would describe your decisiveness and design philosophy? (please check all that apply)

I have a clear sense of my design direction

I am quick to make decisions after seeing a few options

I look forward to seeing new ideas I would never have imagined

I am unsure as to what my style is

I prefer to see many options and choices before making a decision

I am slow to make a decision

I am depending on you, the designer, to guide my choices

Rooms to be included in your project. (please check all that apply)

entire home

entry hall/foyer

family/great room

living room

dining room

kitchen

office/study

nook

laundry/utility room

powder room

master bedroom

bedroom 1

bedroom 2

master bath

bathroom 1

bathroom 2

home theatre/media room

lower level

outdoor area

other

What design elements are being considered for your project? (please check all that apply)

furniture

space planning

artwork and accessories

flooring

interior paint

wall coverings

window treatments

reupholstery

applicances

built-ins/custom

What best describes your style? (please check all that apply)

traditional

eclectic/collected

contemporary

transitional

modern

updated with clean lines

comfortable and relaxed

bohemian and natural

rustic

Entertaining style? (please check all that apply)

small gatherings

large gatherings

I (we) love to cook

music

tv/movies