Form

Kitchen and Bath Creations: Kitchen Design Worksheet
Full Name
First Name Last Name
E-mail

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Home Phone
- Area Code Phone Number
Cell Phone
- Area Code Phone Number
Work Phone
- Area Code Phone Number
Work Phone Ext.
How do you prefer to be contacted?

Email Home Phone Cell Phone Work Phone
Planning Your Project
What type of home project are you planning?

New Construction Remodeling
How long have you been planning your project?

0 to 3 Months 4 to 6 Months 7 to 9 Months 10 to 12 Months Over a year
When would you like to begin this project? (Please give a date)
When would you like to have the project completed? (Please give a date)
Are you currently working with a design professional?

Yes, an architect. Yes, an interior designer. Yes a builder/contractor. No.
What budget range have you established for your cabinets & countertops?
What are your plans in regards to investment in this home?

Long-term Short-term
Is return on investment a PRIMARY concern?

Yes No
Do you plan on renting the jobsite residence in the future?

Yes No
Understanding Your Household
How many adults live in your household?
What are the ages of the adults in your household? (Please check all that apply)

21 to 34 35 to 50 51 to 65 65 and older
How many children reside in your household?
What are the ages of the children in your household? (Please check all that apply)

2 years and under 3 to 6 years 7 to 10 years 13 years and older
How many primary cooks are there in your household?

1 2 Shared cooking duties.
How tall is the primary cook?

5' or under 5'1" to 5'4" 5'5" to 5'9" 5'10" to 6' 6' or taller
Does anyone in your household have any physical limitations that would require special design considerations?

Yes No
If yes please explain.
Defining Your Kitchen Usage
What type of cooking do you normally do?

Heat and serve meals. Full course "from scratch" meals. Bulk cooking for freezing/leftovers.
How often do your entertain guests?

Weekly Monthly Primarily on holidays and special ocassions. Once or twice a year
How would you describe your hosting style (most often)?

Casual Family Style Intimate Couples Only Large Formal Affairs We very rarely entertain.
How would you describe your hosting style (most often)

Casual Family Style Intimate Couples Only Large Holiday Gatherings Dinner Parties (8 to 10 guests) We rarely entertain.
Is your kitchen a socializing place?

Yes. Yes, but I would like to change that. No. No, but I would like it to be.
What secondary activities will take place in your kitchen?

Computer/Home Office Homework Eating Hobbies (Crafting, Sewing) Laundry TV/Radio Wet Bar
Please list other activities which take place in your kitchen.
If applicable, where do you plan to sort recyclables?

Kitchen Laundry Room Garage Other
How often do you shop for groceries?

Daily Weekly Bi-Weekly Monthly
Defining Your Kitchen's Style
What type of feeling would you like your new kitchen space to have? Check all that apply.

Sleek & Contemporary Warm & Cozy Country Open & Airy Formal Traditional Strictly Functional Family Retreat Ecclectic Personal Design Statement
Please select the features that you would like to see in your new kitchen.

New cabinets New countertops New floor New oven New refrigerator/ freezer New cooktop New microwave oven New dishwasher New sink(s) New light fixtures Cutting/chopping surface Waste disposal Trash compactor Recycling center More food prep space More storage Pantry Wet bar New window(s) Desk area Eating area Media/TV center Kitchen Island Breakfast Bar
What do you LIKE most about your present kitchen? (Please be specific)
What do you DISLIKE most about your present kitchen? (Please be specific)
Please share any other information that you believe will be helpful in creating your ideal kitchen.
Thank you for taking a moment to complete this form. Your designer will review this form with you and use it to create a kitchen that best fits your needs and life style.
Should be Empty:

Kitchen and Bath Creations: Kitchen Design Worksheet

Planning Your Project

Understanding Your Household

Defining Your Kitchen Usage

Defining Your Kitchen's Style

Thank you for taking a moment to complete this form. Your designer will review this form with you and use it to create a kitchen that best fits your needs and life style.