ELYSIAN HOME DESIGN
CLIENT INTAKE FORM
Name
First Name
Last Name
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
LOCATION
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
DESCRIBE THE STATUS OF YOUR HOME.
EXISTING HOME
NEW HOME
PRIMARY RESIDENCE
SECONDARY/SEASONAL RESIDENCE
WHAT TYPE OF HOME ARE WE DESIGNING FOR?
APARTMENT/CONDO
TOWNHOME
SINGLE FAMILY HOME
HOW MANY PEOPLE DO YOU SHARE YOUR HOME WITH?
1
2
3
4
5
6
7
8
9
WHO ELSE SHARES THE SPACE WITH YOU?
JUST ME
SPOUSE
KID(S)
PET(S)
PARENTS/IN-LAWS
ROOMMATE(S)
WHAT ROOM(S) ARE YOU INTERESTED IN HAVING DESIGNED?
KITCHEN
BATHROOM
LIVING ROOM/FAMILY ROOM
DINING ROOM
BEDROOM
MASTER BEDROOM
ENTRY
BALCONY/PATIO
WHAT SERVICES ARE YOU INTERESTED IN?
E-DESIGN ONLY
E-DESIGN AND IN-HOME RECEIPT OF FURNISHINGS
E-DESIGN, IN-HOME RECEIPT OF FURNISHINGS, AND IN-HOME STYLING
WHAT DO YOU LIKE AND DISLIKE ABOUT THE SPACE(S)? WHAT ARE YOUR GOALS?
WHERE DO YOU TYPICALLY LIKE TO SHOP FOR HOME ITEMS?
WHAT COLORS DO YOU LOVE? ARE THERE ANY COLORS WE SHOULD OMIT FROM YOUR DESIGN PLAN?
WHAT DESIGN STYLE SUITS YOU BEST? CHOOSE ALL THAT APPLY.
MODERN - MINIMALIST, CLEAN LINES, SOLID FABRICS
ECLECTIC - A BOLD MIX OF SEVERAL STYLES
CONTEMPORARY - MODERN PIECES, STRAIGHT LINES, WARM AND COOL COLORED FABRICS
TRANSITIONAL - UPDATED CLASSICS, MIXED METALS AND GLASS
FARMHOUSE - RUSTIC, SIMPLE, NATURAL WOODS, MATTE METALS
TRADITIONAL - CLASSIC, ORNATE, ANTIQUE
MID-CENTURY MODERN - 50s/60s STYLE FURNITURE, CLEAN LINES, WOOD, LUCITE, PLYWOOD, METALS
COASTAL - WHITE MIXED WITH WARM AND COOL HUES, COMFORTABLE FURNITURE, JUTE, GLASS, WOODS
NAUTICAL - FOCUS ON BLUES, THEMATIC ACCENTS LIKE BOATS, FISH, ETC.
INDUSTRIAL -UTILITARIAN, BASIC, MATTE METALS AND WARM WOODS
BOHEMIAN - LAID BACK, MIX OF COLORS AND PATTERNS, MOROCCAN INFLUENCE
HAVE YOU SAVED INSPIRATIONAL IMAGES OF WHAT YOU'D LIKE THE SPACE TO LOOK LIKE? PLEASE PROVIDE LINKS TO PINTEREST, HOUZZ, ETC.
ESTIMATED BUDGET(INTERIOR DECOR DESIGNS AND ACCESSORIES)?
PREFERRED COMPLETION DATE
-
Month
-
Day
Year
Date
ANY ADDITIONAL COMMENTS OR QUESTIONS?
Submit
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