FAMILY AND LIFESTYLE
1. Number of
household members: ___
2. Number and approximate ages of
household members:
__
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, 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
currently 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
__ Other:___________________ __
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
Do
you serve alcoholic beverages? __ Beer __
Wine __ Mixed
10. How do you shop?
__ For the
week __ Buy in bulk and freeze
__ For each meal __ 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 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
__ Quick & Simple Meals __ Grilling
__ 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. Do the
secondary and primary cook prepare meals
together? __ Yes __ No
9. Is the
secondary cook
__ left handed or __ right handed?
10. How tall is the secondary cook? ________
11. What are the secondary cook's responsibilities?
__ Preparing side
dishes
__ Clean up
__ Assist in preparing main course __ Washing
vegetables
12. Does the
secondary cook have any physical
limitations? ___________________________________________
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 like about your current kitchen?
_______________________________________________________
_______________________________________________________
6. What do you dislike about your current kitchen?
_______________________________________________________
_______________________________________________________
7. Do you require a recycling center in your kitchen?
__ Yes
__ No
If Yes...
How many items do you need to sort? ___
8. Will you be keeping your existing appliances?
Dishwasher:
__ existing __ new
Refrigerator: __ existing __ new
Oven/Range: __
existing __ new
Microwave: __
existing __new
9. What is your style preference for your new kitchen?
__
contemporary __ formal
__ country
__
traditional
TIME AND BUDGET
1. When would you like to begin your project?
_________
_______________________________________________________
2. When would you like your project completed?
________
_______________________________________________________
3. If you are building, is the kitchen in your contract?
__ Yes __ No
4. Do you have a budget for this project?
__ Yes: $ ________________ __ No
GENERAL
1. Name:
_______________________________________________
2. Address:
____________________________________________
3. City:
_______________________ State: ___ Zip: _______
4. Home Phone:
___________________________
5. Work Phone:
___________________________
6. Fax:
__________________________________
7. New Home Address:
___________________________________
8. City:
_______________________ State: ___ Zip: _______
9. Builder Name (if
applicable): _______________________
10. Contact Name:
______________________________________
11. Phone:
_______________________________
12. Fax:
_________________________________
13. Architect Name (if
applicable): ____________________
14. Contact Name:
______________________________________
15. Phone:
_______________________________
16. Fax:
_________________________________
17. Interior Designer Name
(if applicable): ____________
18. Contact Name:
______________________________________
19. Phone:
_______________________________
20. Fax:
_________________________________
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