1. Customer Name*:
2. Street Address*:
3. City, State, Zip*:
4. Phone*:
5. Cell Phone*:
6. E-mail*:
We are committed to protecting your privacy. We collect the information that you voluntarily provide to us
in order to better understand your needs/desires. Your privacy is important to us and we do not share your
information.
General Questions
7. Are you presently working with a decorator or designer?
No
Yes
8. Are you interested in our free of charge decorating and design services?
Yes
No
9. How many are in your household?
10. Are you right handed or left handed?
Right Handed
Left Handed
11. Do you like to cook?
Yes
No
I enjoy:
Baking
Gourmet Cooking
12. Is there more than one cook in the kitchen?
Yes
No
13. Do you entertain frequently?
Yes
No
Moderate
Formally or informally?
Formally
Informally
Both Occasionally
14. What other activities will take place in your kitchen?
15. Type of eating?
16. Number of people normally served at one time?
17. Does your spouse/partner entertain or cook in the kitchen?
Yes
No
If yes, please explain:
Storage Systems
18. What is your cycle of shopping for food?
19. Do you purchase any product in bulk?
Yes
No
If yes, what do you typically purchase in bulk? Please explain:
20. Where do you presently store your food and canned goods?
21. Is storage adequate?
Yes
No
If no, what do you envision having for storage? Please explain:
22. What items would you like in your new kitchen?
23. Does your current kitchen have enough electrical outlets?
Yes
No
If no, please explain:
24. Are your light switches located where you need them?
Yes
No
If no, please explain:
25. Are the plumbing pipes free from leaks?
Yes
No
If no, please explain:
26. Is there a good ventilation system in the cooking center?
Yes
No
If no, please explain:
27. Would you like a new single or double bowl sink?
28. What kind of sink do you want?
29. Would you like an Under-Mount or Top-Mount Sink?”
30. Are you interested in new appliances supplied directly through Hibiscus Building Group at wholesale?
Yes
No
If so, what finish are you interested in?”
31. Do you have a brand preference?
32. Do you want any panel ready appliances so that the front will match the cabinetry?
Yes
No
If so, which ones?
33. Do you have a microwave oven conveniently located?
Yes
No
34. Do you want to reuse your cooktop?
Yes
No
35. Do you want to reuse your oven?
Yes
No
36. Do you want to reuse your stove?
Yes
No
37. Do you want to reuse your refrigerator?
Yes
No
38. Do you want to reuse your dishwasher?
Yes
No
39. Do you want to reuse your microwave?
Yes
No
40. Are you interested in putting in a wine fridge?
Yes
No
41. What kind of finish do you want on your faucet?
42a. Approximately what size is your kitchen?
42b. Have you considered changing the location of doors and windows?
Yes
No
If yes, please explain:
43. Does the kitchen relate to adjacent rooms the way you would like?
Yes
No
If no, please explain:
44. Is the view from the kitchen to the outside where you would like it to be?
Yes
No
If no, please explain:
45. Would you like a casual dining/conversation area in the kitchen?
Yes
No
If yes, please explain:
46. What is your color preference?
47. What type of cabinetry would you prefer?
48. If you chose wood, what is your preferred wood material?
49. What is your preferred color tones for the cabinetry?
50. How old is your home?
51. Is this the original kitchen?
Yes
No
52. Do you want your new kitchen to have a particular look?
53. What kind of countertop do you want?
54. Do you presently have a backsplash?
Yes
No
55. Are you interested in adding a backsplash?
Yes
No
If yes, which one?
56. If you chose tile backsplash, what is your tile material preference?
57. What price range do you think you'd like to stay in and still provide you with what you want?*
Including appliances?
Yes
No
58. Additional comments or questions:
