REMODEL QUESTIONNAIRE DATE SUBMITTED(Required) MM slash DD slash YYYY FIRST & LAST NAMES OF ALL DECISION-MAKERS(Required) EMAIL(Required) PHONE(Required)ADDRESS(Required) Address City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country BIRTHDAY(Required) MM slash DD slash YYYY ANNIVERSARY (IF APPLICABLE) WHAT’S THE BEST WAY TO COMMUNICATE WITH YOU? CLICK ALL THAT APPLY(Required) Phone call Text Email HOW DID YOU HEAR ABOUT US?(Required)BNICONTRACTOR OR ARCHITECTFACEBOOKFRIENDGOOGLEHOUZZINSTAGRAMMAGAZINEPINTERESTPREVIOUS CLIENTYOUTUBEOTHERI AM A…(Required)HOMEOWNERDESIGNERCONTRACTORINVESTORPROJECT TYPE(Required)RESIDENTIALCOMMERCIALHOSPITALITYMULTI-FAMILYHOW MANY PEOPLE WILL BE LIVING IN YOUR HOME OR ARE IN YOUR BUSINESS? WHAT ARE THEIR AGES?(Required)DO YOU OR ANYONE IN YOUR FAMILY HAVE ANY SPECIAL NEEDS?(Required)DO YOU HAVE PETS? WHAT TYPES?(Required)DO YOU ENTERTAIN OFTEN? HOW MANY PEOPLE USUALLY?(Required)HOW WOULD YOU DESCRIBE YOUR DESIGN STYLE? CHECK ALL THAT ARE APPLICABLE(Required) MID-CENTURY MODERN TRADITIONAL COASTAL RUSTIC RETRO MODERN FARMHOUSE BOHEMIAN SHABBY CHIC CONTEMPORARY COUNTRY ECLECTIC HOLLYWOOD GLAM TRANSITIONAL INDUSTRIAL MINIMAL VINTAGE SOUTHWESTERN OTHER Other HOW WOULD DESCRIBE YOUR DECISIVENESS AND DESIGN PHILOSOPHY? (PLEASE CHECK ALL THAT APPLY)(Required) I HAVE A CLEAR SENSE OF MY DESIGN DIRECTION I AM QUICK TO MAKE DECISIONS AFTER SEEING A FEW OPTIONS I LOOK FORWARD TO SEEING NEW IDEAS I WOULD NEVER HAVE IMAGINED I AM UNSURE AS TO WHAT MY STYLE IS I PREFER TO SEE MANY OPTIONS AND CHOICES BEFORE MAKING A DECISION I AM SLOW TO MAKE A DECISION I AM DEPENDING ON YOU, THE DESIGNER, TO GUIDE MY CHOICES PLEASE ATTACH ANY EXISTING PHOTOS AND/OR FLOOR PLANSAccepted file types: pdf, doc, docx, jpg, png, jpeg, Max. file size: 32 MB.WHAT IS YOUR PINTEREST OR HOUZZ NAME?(Required) WHERE IS YOUR FAVORITE PLACE TO TRAVEL?(Required) WHAT ARE SOME OF YOUR HOBBIES?(Required)*RANK THESE IN ORDER OF IMPORTANCE: STYLE / QUALITY / AFFORDABILITY(Required)WHAT IS YOUR ANTICIPATED BUDGET?(Required)$25,000-$50,000$50,000-$75,000$75,000-$100,000$100,000-$150,000$150,000-$200,000$200,000-$250,000$250,000-$500,000$500,000+WHAT IS YOUR IDEAL START DATE?(Required) MM slash DD slash YYYY ARE YOU CURRENTLY WORKING WITH A CONTRACTOR OR ARCHITECT?(Required)DESCRIBE THE SCOPE OF YOUR PROJECT. WHAT ROOMS DO YOU WANT TO REMODEL? (PLEASE CHECK ALL THAT APPLY) ENTIRE HOME ENTRY HALL/FOYER FAMILY/GREAT ROOM LIVING ROOM DINING ROOM KITCHEN OFFICE/STUDY NOOK LAUNDRY/UTILITY ROOM POWDER ROOM MASTER BEDROOM BEDROOM 1 BEDROOM 2 MASTER BATH BATHROOM 1 BATHROOM 2 HOME THEATRE/MEDIA ROOM LOWER LEVEL OUTDOOR AREA OTHER IF OTHER, PLEASE SPECIFY: WHAT DOES YOUR FAMILY (OR IF A BUSINESS – YOUR TEAM) NORMALLY DO IN THIS ROOM OR ROOMS?(Required)WHAT DO YOU LOVE ABOUT THE CURRENT DESIGN/SPACE? WHAT DO YOU DISLIKE?(Required)WHAT ARE YOU ENVISIONING THE SPACE TO LOOK LIKE WHEN IT’S COMPLETE & WHAT ARE YOU HOPING TO ACHIEVE WITH THE NEW DESIGN?(Required)DO YOU WANT YOUR DESIGN DONE IN PHASES OR ALL AT ONE TIME?(Required)WHAT COLORS AND/OR MATERIALS DO YOU LIKE/DISLIKE?(Required)WILL THERE BE ANY FINISHES/FIXTURES THAT YOU WANT TO KEEP?(Required)WOULD YOU LIKE TO BE INCLUDED ON OUR EMAIL LIST? IT INCLUDES STYLE TIPS + TRICKS, SHOPPING RESOURCES AND ANY SPECIALS I MAY BE HAVING.(Required)YESNO THANKSI’M ALREADY ON ITADDITIONAL COMMENTS: Contact Us 480.227.0064 Ask me about Gift Cards! Get In Touch Name Email Address Phone Your Message 4 + 6 = Send Email FollowFollowFollowFollowFollow
