CHIC INTERIORS CLIENT SHEET

CHIC INTERIORS CLIENT SHEET
Name

FIRST NAME LAST NAME
Street Address
City
State
Zip Code
Phone
Email
example@example.com
Name of person authorizing decisions on design & purchase
Do you wish to sign up for our newsletter and receive exclusive deals?

Yes No
Preferred Method of Contact

Call Text Email
Referral Source

Home Advisor Thumbtack Internet Facebook Instagram Friend/Family Pinterest Houzz
What is your Pinterest user name?
What is your Houzz user name?
Is your project a...?

Current Home Remodel New Construction
Project Start Date

Month Day Year
Date
Project Completion Date

Month Day Year
Date
Service Requested
Project Size

One Room Two Rooms Three Rooms 4 or more
Do you...?

Own Rent
Rooms Servicing

Living Room Great Room Dining Room Kitchen Pantry Bathroom Main Bedroom Guest Bedroom Office Kids BR/Nursery Other
Other information you would like to provide
Should be Empty: