Please take a few moments to complete the information requested below.  Brief answers are fine, use the back of these sheets if you would like to provide more information.  Involve you entire household.  Have fun telling us about your wants and needs.  We would like to take full advantage of the time we share together and your input is essential.  Thank you for your cooperation.  All information will be kept confidential.

Primary Contact Information: Date:
Contact #1: Contact #2:
Name: Name:
Day Phone: Day Phone:
Evening Phone: Evening Phone:
Cell Phone: Cell Phone:
Fax: Fax:
Email: Email:
How would you prefer to be contacted? (Check all that apply)
Work Phone: Home Phone: Email: Cell: Day: EVE:
Household Information
House square footage: Age of House:
# Bedrooms: # Baths:
Who lives in your home and what are their ages? (Will your rooms need to serve different functions in the future for any household members?)
Is your household more casual or formal?
Project Information
Person(s) responsible for project decisions:
What is the complete budget for you project?
$5,000-$10,000: $10,000-$30,000:
$40,000-$90,000: $100,000-$200,000 Other:
• Construction Project: $
• Furnishings Portion: $
The project is to be done:
• Will occupants be home during project/construction for access?
• If not, will you authorize a key for us to access the home?
Please “X” the rooms to be included in the project. If the project will be done in stages, please indicate the order of the work by writing a number in the box to show the order (1-first, 2-second, etc.)
Entry Hall/Foyer: Formal Living Room: Kitchen:
Family/Great Room: Formal Dining Room: Nook:
Office/Study: Laundry Area: Master Bedroom:
Master Bathroom: Hall Bathroom: Guest Bathroom:
Bedroom #2: Bedroom #3: Bedroom #4:
Home Theater/Media Room: Outdoor Kitchen: Other:
Outdoor Living Area: Other: Other:
What kind of enhancements are you considering?
Furniture: Remodel Kitchen: Flooring: Reupholstery:
Window Treatments: Remodel Bathroom: Interior Paint: Exterior Paint:
Wallpaper/Wall Finishes: Space Planning: Plumbing Fixtures: Appliances:
Lighting: Color Scheme: Room Addition: Artwork/Mirrors:
What is your favorite room in the house, and why?
What don’t you like about your current home, and why?
What part of your house do you use the most?
What part of the house do you use the least?
What is your “ideal” timeline for your project?
**Based on the scope of the work the timeline and completion on the project will be decided at time of consultation
Would you like to schedule a consultation at this time?
Design Preferences
Design Goals:
Prioritize the following personal design goals for you home from 1-3, with 1 being your most important quality.
I am interested in achieving a more stylish/beautiful appearance for my home
I want my home to function more effectively for my household
I want my home to better reflect our personal tastes
Have you ever hired an interior designer before? Yes | No
If yes, when did this take place, and were you please with the experience and results:
Any additional notes for us to consider while designing and/or regarding your preferences: