Date of First Contact *

MM

DD

YYYY

Name *

First Name

Last Name

Client Home

(###)

###

####

Client Cell *

(###)

###

####

Any other Number needed

(###)

###

####

Project Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Billing Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Have you ever worked with a designer before? *

No

Yes

Rent or Own the project property?

Rent

Own

Preferred Project Start Date *

MM

DD

YYYY

Target Completion Date *

MM

DD

YYYY

Move In Date

If applicable

MM

DD

YYYY

Contractor's Phone Number

(###)

###

####

Client willing to purchase items on their own ei. Craiglist? *

Yes

No

What spaces are you interested in having designed? *

Click all that apply

Kitchen

Dining Room

Breakfast Nook

Kitchenette

Bathroom

Living Room

Family Room

Entry Way

Office

Kid Bathroom

Guest Bathroom

Master Bathroom

Master Bedroom

Kid Bedroom

Nursery

Guest Room

Mudroom

Laundry

Hallway

Outdoor Space

Other

What colors are you drawn to/or do you see in this space(s)? *

Warm Colors (reds, oranges, golds, warm browns, warm grays)

Cool Colors (blues, greens, grays, cool browns, cool grays)

Neutrals

Pastels

Jewel Tones

Bold Colors

White

Who will occupy the room(s) at any given time? *

Select all that apply.

You

Family

Guests

Do you want the room(s) to be kid friendly? *

Yes

No

Will you permit me to share this project on my blog? *

Such as before and after pictures, progress pictures.

Yes

No

WIll you permit me to display this project in my portfolio?

Yes

No

Level of comfort required in space(s)? *

Not Precious

Semi Precious

Precious

Services Needed for Completion of Project *

Click on all that apply.

In-Home Design Consultation

Space Analysis & Furniture Placement

Custom Cabinetry Design

Selection of Finishes

Furniture Sourcing

Purchasing / Tracking / Delivery

Project Management

Styling & Accessorizing