CHIC INTERIORS CLIENT SHEET
Today's Date
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Month
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Day
Year
Date
Name
FIRST NAME
LAST NAME
Street Address
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State
Zip Code
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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?
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No
Preferred Method of Contact
Call
Text
Email
Referral Source
Home Advisor
Thumbtack
Internet
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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
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Month
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Day
Year
Date
Project Completion Date
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Month
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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
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