Family and Lifestyles
1. Number of family members: ___
2. Number and approximate ages of family members:
__ infants __ young children __ teens ___ pets
__ 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, will they be using
the kitchen frequently? __ Yes __ No
4. How long do you plan on living in the home you are
remodeling/building?
__ 1 to 5 yrs __ 6 to 10 yrs __ 11 to 20 yrs __20+
5. Where does your family eat its meals?
__ Kitchen __ Dining Room
__ Other:______________________
6. Where will your family eat after you remodel/build?
__ Kitchen __ Dining 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 other options
__ 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
__ Hobbies __Planning Desk __Growing Plants
__ Cake Decorating __ Wet Bar
___Other___________________________
9. After your remodel/build will you entertain
frequently? __ Yes __ No
If Yes...
What is your entertainment style?
__ formal __ informal
Do you have __ large or __ small gatherings?
Do your guests help you in the kitchen when
you entertain? __ Yes __ No
10. How do you shop?
__ For the week __ Buy in bulk and freeze
__ Bi-Weekly
__ For each meal
__ Buy in Bulk and Freeze
__ No Bulk
__ 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
11. Do you need storage for canned foods?
__ Yes __ No
12. Where do you presently store tall cleaning
and ironing equipment?__________________
13. Specialized storage desired
__ Pantry __Rollouts __Vertical Storage
__ Small Appliance Center __Lazy Susan
__ Extra Breadboard __Cutlery Dividers
__ Spice Storage __Wine Rack
__ Cookbook Storage __Bottle Storage
__ Bulk Storage __ Tray Storage
__ Vegetable Storage __Towel Bar
__ Linen Storage __Hostess Cart
___Other___________________________
__ Hobbies __Planning Desk __Growing Plants
__ Cake Decorating __ Wet Bar
___Other___________________________
__ Hobbies __Planning Desk __Growing Plants
__ Cake Decorating __ Wet Bar
___Other___________________________
Cooking Style
1. Who is the primary cook? ____________________________
2. Is the primary cook __ left handed or __ right handed?
3. How tall is the primary cook? _______
4. What is the primary cook's cooking style?
__ Gourmet Meals __ Family Meals
__ Speciality Cooking __ Canning
__ Quick & Simple Meals
__ Bringing Meals Home __ 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 visiting during meal preparation.
6. Does the primary cook have any physical limitations?
__ Yes __ No
7. Who is the secondary cook? _________________
8. Does the seconday cook entertain or cook in the
kitchen? __ Yes __ No
9. Do the secondary and primary cook prepare meals
together? __ Yes __ No
10. Is the secondary cook
__ left handed or __ right handed?
11. How tall is the secondary cook? ________
12. What are the secondary cook's responsibilities?
__ Preparing side dishes __ Clean up
__ Assist in preparing main course
13. Does the secondary cook have any physical
limitations? ___________________________________________
Design and Style
1a. What are your color preferences for your new kitchen?
_______________________________________________________
1b. What are your husband's 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. Has anyone else tried to assist or made a plan for you?
__Yes __No Who ___________________________
6. What do you like about your current kitchen?
_______________________________________________________
_______________________________________________________
7. What do you dislike about your current kitchen?
_______________________________________________________
_______________________________________________________
8. Do you require a recycling center in your kitchen?
__ Yes __ No
If Yes...
How many items do you need to sort? ___
9. Will you be keeping your existing appliances?
Dishwasher: __ existing __ new
Refrigerator: __ existing __ new
Oven/Range: __ existing __ new
10. What is your style preference for your new kitchen?
__ contemporary __ formal
__ country __ traditional
11. What is the size of the kitchen table? ____________
12. Number of people normally served at one time? ___
Time and Budget
1. When would you like to begin your project? _________
_______________________________________________________
2. When will the cabinets be needed? ____________
3. When would you like your project completed? ________
_______________________________________________________
4. Do you wish for the cabinets to be delivered? __Yes __No
5. If you are building, is the kitchen in your contract?
__ Yes __ No
6. Do you have a budget for this project?
__ Yes: $ ________________ __ No
GENERAL
1. Name: _______________________________________________
2. Address: ____________________________________________
3. City: _______________________ State/Prov.: ___ Zip/Postal:
_______
4. Home Phone: ___________________________
5. Work Phone: ___________________________
6. Fax: __________________________________
7. New Home Address: ___________________________________
9. City: _______________________ State/Prov: ___ Zip/Postal:
_______
10. BuilderContractor Name (if applicable): _____________________
11. Contact Name: ______________________________________
12. Phone: _______________________________
13. Fax: _________________________________
14. Architect Name (if applicable): ____________________
15. Contact Name: ______________________________________
16. Phone: _______________________________
17. Fax: _________________________________
18. Interior Designer Name (if applicable): ____________
19. Contact Name: ______________________________________
20. Phone: _______________________________
21. Fax: _________________________________
