Style Questionnaire Form

1
Name* This field is required.
Mr.
Mr.
Mrs.
Ms.
Prefix
First Name
Last Name
2
Email* This field is required.
example@example.com
3
AddressMust include for in-person project requests.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
4
Phone Number* This field is required.
Area Code
Phone Number
5
Preferred primary method of contact.* This field is required.Please limit phone calls and text messages to business hours (Monday-Friday 9 a.m. - 5 p.m.) unless we have an appointment after hours, of course.
Call
Email
Text
6
Are you moving to the new address? If yes, when will you be in the new space?* This field is required.
7
What type of home is it?* This field is required.
Apartment/Condo
Single family home
Duplex or townhome
Office space
8
What rooms of the house would you like to address with this design service?* This field is required.Please select all that apply!
Kitchen
Bathroom
Living Room
Owner's Bedroom
Powder Room
Guest Room
Kid Room
Teen Room
Nursery
Laundry Room
Patio/Outdoor Area
Entryway
Office
Owner's Bathroom
Other
9
Your Age Range* This field is required.
18-24
25-34
35-44
45-54
55-64
65+
10
Who else will or currently shares the space with you?* This field is required.
Myself
Spouse
Significant Other
Cat(s)
Dog(s)
Other Pet
Kid(s)
Parent(s)/Inlaw(s)
Roommates
11
How often do you use the space we'd like to work on? * This field is required.
12
What types of activities do you like to use the space(s) for specifically?* This field is required.Please select all that apply
Cooking
Dining
Watching TV/Movies
Reading
Board Games
Restroom
Hosting events with 8 or more guests
Video games
Sleeping
Working from home
Storage space - work
Storage space - personal
Exercise with large weights/cardio machines
Exercise with minimal equipment, ie. yoga mat/hand weights
Crafting
Other
13
What do you currently like MOST about this space or your home in general?Share what's working for you!
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14
How many people live or will live in the home?* This field is required.
1
2
3
4
5
6+
15
Who will be responsible for the approval of design concepts/purchases for your space?* This field is required.
16
How did you hear about Kaitlyn Loos Design? * This field is required.
17
If you've selected full-service design, how hands-on would you like to be?* This field is required.
I am not opting for full-service at this time, but maybe in the future!
Almost completely hands-off. I'm very busy and would like to receive as few emails as possible. I trust designers and don't need to get in the way!
Moderately hands on. I'm okay with multiple check-ins a week. Just don't ask me to shop!
Hands-on. I enjoy reading and watching programs on the topic of interior design and have completed some projects in my home on my own that I'm proud of. I'd love to shop with you in person when possible, since that's personally fun for me!
Hands all over it. I want to approve every purchase line by line. I want to ultimately make all final selections with minimal input from the service. (In this case, I recommend updating to a strategy session so that you can get the best result for your capabilities and preferences.)
18
What is your timeline for completing this project?* This field is required.
ASAP
In next month
Flexible
In the next 2-3 months
Within the next 4-6 months
Other
19
Have you worked with an interior design professional in the past?
YESNO
20
If yes, how did you feel the process went in the past?Feel free to skip this question if this is your first time working with an interior design professional.
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21
If you can wave a magic wand and instantly get a fix for three (3) problems in your home, what problems would you want solved? * This field is required.
22
Now for some style questions! From the images below, please select the entryway photo that most represents your ideal style.* This field is required.Tip: Zoom in on your screen to see these image selections larger. These images are meant for inspiration and style selection only. They are not owned by Kaitlyn Loos Design.
23
In the past five years, what stores have you purchased furniture or home accessories from that you STILL love today?* This field is required.Please select all that apply
Pottery Barn
Home Goods (Marshalls, etc.)
Ashley Home Store
West Elm
World Market
Restoration Hardware
Crate & Barrel
Wayfair (Joss & Main, etc.)
Kirkland's
Target
Amazon Home
Macy's
Anthropologie
Urban Outfitters
Pier 1
American Signature Furniture
Hudson's Furniture
IKEA
Rooms 2 Go
Magnolia.com
Z Gallerie
Ballard Designs
Old Time Pottery
Other
24
Select your favorite accent chair from the options below. * This field is required.These images are meant for inspiration and style selection only. They are not owned by Kaitlyn Loos Design.
25
Select the color palette which appeals most to you. * This field is required.Zoom your screen to get a better look at the options! These images are meant for inspiration and style selection only. They are not owned by Kaitlyn Loos Design.
26
Optional: Please upload between 1 and 5 images that represent the look and feel you are inspired to accomplish similarly in your space.Feel free to skip if you don't have these.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
27
Any other notes you'd like to add about your style? You can also link a Pinterest Board with 1-5 key images selected.
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28
Last question! Any other important considerations that you would like to include that have not been part of this survey?
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