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Kitchen
Planning Questionnaire
General Information:
Name: __________________________________________________________
Address: ________________________________________________________
City & Zip: _______________________________________________________
Home Phone: ____________________________________________________
Mobile Phone: ____________________________________________________
Fax: ____________________________________________________________
Primary Cook:
Age___ Height___ Male or Female
Right-handed or Left-handed
Secondary Cook:
Age___ Height___ Male or Female
Right-handed or Left-handed
Other Family Members:
Age___ Male or Female
Age___ Male or Female
Age___ Male or Female
Age___ Male or Female
Age___ Male or Female
Age___ Male or Female
1. How long do you plan on living in the home you are remodeling/building?
1 – 5 years
6 – 10 years
11 – 20 years
20 + years
2. Where will your family primarily eat after you remodel/build?
Kitchen Table
Island
Dining Room
Other: __________
3. Will you require a kitchen table?
YES
NO
4. What other activities will take place in your new kitchen?
Laundry
Homework
Watching TV
Paying Bills
Computer work
Other: _______________
5. What is your entertainment style?
Formal
Semi-Formal
Informal
6. After you remodel/build will you entertain frequently?
YES
NO
If yes, how often? _____/year
7. Do your guests help you in the kitchen?
YES
NO
8. What size are your gatherings?
Small (up to 10 people)
Medium (10-20 people)
Large (20+ people)
9. How do you grocery shop?
a. for the week
b. for each meal
c. buy canned/boxed items in bulk
d. buy in bulk and freeze
10. Does the primary cook have any physical limitations?
YES
NO
If yes, what type? _______________
11. If a design could be greatly improved, would you be willing to make structural changes? (i.e. moving windows, doors, or walls)
YES
NO
If yes, what changes? ________________
12. What do you like/dislike about your current kitchen?
Like: ________________________________________________________
_____________________________________________________________
_____________________________________________________________
Dislike: ______________________________________________________
_____________________________________________________________
_____________________________________________________________
13. Which of your existing appliances will you be using in your new kitchen?
Dishwasher Refrigerator Oven
Range/Cooktop Microwave
14. If known, which new appliances will you be purchasing?
Dishwasher Make: _______________ Model #: ________________________
Refrigerator Make: _______________ Model #: ________________________
Range Make: _______________ Model #: ____________________________
Cooktop Make: _______________ Model #:
__________________________
Oven Make: _______________ Model #:
_____________________________
Microwave Make: _______________ Model #: ________________________
Other: _________ Make: _______________ Model #: __________________
Other: _________ Make: _______________ Model #: __________________
15. Do you have a budget for this project?
YES: ____________ NO
16. How did you hear about us?
Magazine Ad Phonebook
Website
A Friend or Relative Saw our sign
Other:_______________
Design Features
Cabinetry Wood Preference:
Cherry Maple Oak
Pine Birch
Hickory Paint Grade Wood MDF
Other:__________
Finish Preference:
Stain Stain with Glaze Paint
Paint with Glaze Other:__________
Cabinetry Door Style:
Flat Panel Raised Panel Other:__________
Cabinetry Overlay Style:
Square Inset Beaded Inset Full Overlay
Traditional Overlay
Other:__________
Please CIRCLE the number that applies to your new kitchen project.
1- Very Important 2- Somewhat Important
3- Not Important 4-Not Applicable
Pull-out Trash 1 2
3 4
_____________________________________
Recycling Center 1 2 3 4
__________________________________
Vegetable Sink 1 2 3 4
____________________________________
Cutlery Dividers 1 2 3 4
___________________________________
Tray Dividers 1 2 3 4
_____________________________________
Roll-Out Trays 1 2 3 4
____________________________________
Island 1 2 3 4
___________________________________________
Bar Seating
1 2 3 4
______________________________________
Glass Doors 1 2 3 4
_____________________________________
Appliance Panels 1 2 3 4
__________________________________
Spice Storage 1 2 3 4
____________________________________
Wine Storage 1 2 3 4
_____________________________________
Open Shelving 1 2 3 4
____________________________________
Other Features:___________________________________________________
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