NEW CLIENT INTAKE FORM

NEW CLIENT PROJECT FORM
Name

First NameLast Name
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Date

MonthDayYear
Date
Type of Consult preferred
Approximate start time of project
Type of Project
Kitchen size
General scope of project ( select all that apply )

New cabinets and decorative hardwareNew countertopsWall tileFlooringNew sink and faucetNew AppliancesPlumbingElectricalPaintingDemo existing kitchenOther
How many family members are in your household ?
How does your family use the kitchen for meals at home? ( check all that apply)

Daily heat and serve mealsDaily from "scratch" mealsWeekend quantity cookingWeekend family mealsSchool lunchesEthnic or specialty cookingOther
How many years do you intend to stay in your home?
What do you dislike most about your current kitchen?
What do you like most about your current kitchen?
Appliances that will be in kitchen ( choose all that apply ) This is to get a placeholder for the preliminary design. Details will be discussed during your consult.

30" range or cooktop36" range or cooktopUnder cabinet Range hoodDecorative range hood ( is not attached to cabinetry )24" dishwasher36" refrigeratorBuilt in microwaveFree standing microwaveCountertop coffee potCountertop toasterCountertop MixerWine refrigeratorBeverage refrigeratorSingle wall ovenDouble wall ovensOther
Check any of the following Sustainable Design features that you'd like to see incorporated into your design

water sense faucetsenergy efficient appliancesLED task lightingAreas for trash and recyclingIncorporate natural wood and plants ( Biophilic Design )
Seating preference ( check all that apply )

Separate tableIsland or peninsula with 30" tall seatingIsland or peninsula with 36" counter height seatingIsland or peninsula with 42" bar height seating
Select any features that you'd like to include in your design if possible

Wine / liquor storageBulk food storageWater bottle / to go food storageHomework / school supply storage areaPet feeding station / food storageDrop zone ( message board, phone charging etc. )Lazy susanRoll out shelvesTrash roll outSilverware organizerTray divider cabinetSpice organizerGlass Doors
Additional notes / requests
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NEW CLIENT PROJECT FORM