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Modern Kitchen Design

Modern Kitchen Design Questionnaire

The following questionnaire will help to give us here at Modern Kitchen Design a better idea of how to more
accurately suit your needs. Please take a moment to print this questionnaire, fill it out and submit it back to your designer.

General Information

Name:

Address:

City:

State:

Zip:

Home Phone:

Cell Phone:

Email Address:

How Did You Hear About Us?:

I'm Inquiring About:

	Kitchen		Entertainment Center
	Bathroom		Bar
	Office

If building a new home, please indicate the following:

New Address:

Builder's Name:

Builder's Phone:

Builder's Fax:

Architect's Name: (if applicable)

Architect's Phone:

Architect's Fax:

Time and Budget

Preferred project start date:

Preferred project completion date:

What is your budget for this project?:

If you are building a new home, is the kitchen
included in your contract?

Yes

Family and Lifestyle

Please indicate the number of adults and
children currently residing at home:

Please indicate the age and sex of each
person residing at home:

How long do you anticipate living in the
home you are remodeling/building?

Generally, where does your family eat?

In regards to your kitchen table, is one absolutely essential - or would you be interested in exploring alternative dining design options?

Do you use your kitchen for
any other activities?

	Homework		Paying Bills
	Laundry		Home Office
	Watching TV

Once your project is completed, do you
expect to entertain regularly?

Yes

When entertaining, does your style tend to
be more formal or informal?

Formal

Informal

When entertaining, do your gathering
regularly include more than 15 people?

Yes

When preparing for such events, do
your guests assist you in the kitchen?

Yes

When shopping for meals, which is
your preferred shopping method:

For items bought in bulk, will you require
kitchen storage for these items?

Yes

Would you like a recycling center in your kitchen?

Yes

Design Preferences

What are your color preferences
for your new kitchen?

Are there any colors that you would
specifically not want in your new kitchen?

What is your kitchen-style preference?

For remodeling projects, would you be willing to make structural changes - for example, moving doors, changing walls, adding/removing windows?

Also, for remodeling projects, please indicate
which appliances you will keep or replace:

Dishwasher:	Keep	Replace
Refrigerator:	Keep	Replace
Oven/Range:	Keep	Replace
Microwave:	Keep	Replace

Please list what you like
about your current kitchen:

Please list what you dislike
about your current kitchen:

Cooking Style

In your family, is there one family
member who is the primary cook?

Yes

Is this primary cook left- or right-handed?

Left

Right

How tall is the primary cook?

What is this cook's cooking style?

	Elaborate, gourmet meals		Family meals
	Quick and simple meals		Baking

When the primary cook prepares meals,
which of these usually occurs:

Is there a secondary cook?

Yes

Is this secondary cook left- or right-handed?

Left

Right

How tall is the secondary cook?

What are the secondary cook's responsibilities?

	Preparing Side Dishes
	Clean Up Duties
	Assist in Preparing Main Course

Do either the primary or secondary cook
have any physical limitations?

Do the two cooks often prepare meals together?

Yes

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