1. Number of family members: 

2. Please check the age ranges in your family:
Infants   Young Children  Teens  20 to 30 Yrs.
31 to 40 Yrs. 41 to 50 Yrs.  51 to 60 Yrs.  61 to 70 Yrs. 
70+  

3.  If your family has young children, with they be using the kitchen frequently?  Yes No

4.  How long do you plan to live in the home after remodeling?
1 to 5 Yrs.   6 to 10 Yrs.   11 to 20 Yrs.    20+

5.  Where does your family eat its meals?
Kitchen  Dining Room  Den TV Room Other 
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6.  Where does your family eat after the remodel?
Kitchen  Dining Room  Den  TV Room Other

7. Do you require a kitchen table or would you be willing to explore other options if a design could be improved?
A kitchen table is required.
A kitchen table is preferred but open to suggestions.
A kitchen table is not necessary.

8. What other activities will take place in your new kitchen?
Laundry          Homework         Watching TV      Paying Bills   
Sewing           Computer Center  Other            

9. After your remodel/build will you entertain frequently?  Yes No

10.  What is your entertainment style? Formal Informal
xxx
11.  Do you have large or small gatherings?  Large Small

 12.  Do your guests help you in the kitchen when you entertain?  Yes No

13. How do you shop?
For the week
For each meal
Buy in bulk and freeze*
Buy non-perishable items in bulk

*If you buy in bulk, do you require storage in the kitchen for all or most of these items?  Yes No

Cooking Style

1. Who is the primary cook?   

2.  Is primary cook right or left handed?  Right   Left

3.  How tall is the primary cook?  

4. What is the primary cook's cooking style?
Gourmet Meals  Quick & Simple Meals   Bringing meals home
Family meals Baking

5. What does the primary cook prefer?
No one else in the kitchen while preparing meals
A helper in the kitchen when preparing meals.
Family or friends in the kitchen during meal preparation.

6. Does the primary cook have any physical limitations?   Yes No

7. Who is the secondary cook?  

8. Do the secondary and primary cook prepare meals together?   Yes No

9.  What are the secondary cook's responsibilities?
Preparing side dishes
Assist in preparing main courses
Clean Up

10. Does the secondary cook have any physical limitations?   Yes No

Design and Style

1. What are your color preferences for your new kitchen?  

2. Are there colors you would not want in your new kitchen?  

3. Have you created a scrapbook of notes, photos, and ideas that you would like to use in your new kitchen?   Yes No

4. If a design could be greatly improved, would you be willing to make structural changes? (i.e. moving windows, doors, and walls)?  Absolutely Not    I would consider it

5. What do you dislike about your current kitchen?


6. Do you require a recycling center in your kitchen?   Yes No

7. How many items do you recycle?  

8.  Do you plan to use your existing appliance or desire a new one?
Refrigerator:  Existing New
Dishwasher:   Existing  New
Oven / Range: Existing New

9. What is your style preference for your new kitchen?

Contemporary Formal
Country Traditional


10. When would you like to begin your project?    

11. When would you like your project completed?

12. If you are building, is the kitchen in your contract?   Yes No

13. Do you have a budget for this project?     Yes No
If so - how much?   

Contact Information

Name Age
Sex Male Female Height
xxx
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
FAX
E-mail
  • Architect contact information:

    Name
    Organization
    Work Phone
    FAX
    E-mail
    xxx
  • Interior Designer Contact Information

    Name
    Organization
    Work Phone
    FAX
    E-mail

    Please copy and paste in your email and send to mike at teevax com

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