Contact Information:
Name:
First Name
Last Name
E-mail:
Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
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Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
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Brunei
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Burkina Faso
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Cape Verde
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Chile
China
Christmas Island
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El Salvador
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Netherlands Antilles
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Nigeria
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eSwatini
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Western Sahara
Yemen
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Other
Country
Phone Number:
-
Area Code
Phone Number
Birthday:
How did you hear about us today?
Household Information:
Children In The Home:
None
0-4y/o
5-12y/o
13y/o+
Pets in the home:
Yes
No
Lifestyle:
Entertaining lifestyle:
Casual
Formal
Hobbies and Activities:
Colors you're most attracted to:
Neutrals
Cool Tones (Blues/Greens)
Warm Tones (Reds/Oranges)
Colors you don't care for:
Which of these best describes your style:
Modern
Modern Farmhouse
Transitional
Traditional
Urban
Rustic
Eclectic
Project Information:
Person(s) responsible for project decisions:
Project is to be done:
All at once
In stages
Within the next 3 months
Within the next 6 months to 1 year
Please check all of the rooms to be included in the project:
Whole House
Family Room
Kitchen
Dining Room
Entry/Foyer
Bedrooms
Bathrooms
Office/Study
Basement
Kids' Rooms
Other
What kind of enhancements are you considering? (please check all that apply)
Furniture
Window Treatments
Accessories
Lighting
Flooring
Paint/Finish Selections
Kitchen Remodel
Bathroom Remodel
Basement Remodel
Whole House Remodel
New House Build
Other
How involved do you wish to be in this project?
Very involved. I just need some initial guidance and will finish the project on my own.
Involved. I'd like to work as a team with Black Dog Design House to complete my project.
Minimally involved. We will mutually agree on an overall design and budget for this project, but Black Dog Design House is free to do their thing!
Other
What is your budget for this project (including furniture, accessories, flooring, window treatments, etc)?
Less than $10,000
$10,000-$25,000
over $25,000
Please give a brief description of the project:
Décor Style
Houzz account:
Pinterest account:
Instagram account:
Where do you like to shop for furnishings & accessories?
Please arrange these design attributes in order of importance, 1 being the most important:
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