Name *

First Name

Last Name

Phone *

(###)

###

####

Project Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Scope of Project *

Renovation

Furnishings

Budget for Project *

$100,000-$150,000

$150,000-$250,000

$250,000-$500,000

$500,000-$1,000,000

Check all that apply *

Complete Home

Kitchen

Living Room

Dining Room

Foyer

Powder Room

Primary Bedroom

Primary Bathroom

Guest Bedroom

Guest Bathroom

Home Office

Window Treatments

Outdoor Living

Is there a significant other involved with making decisions? *

Yes

No

Have you worked with a designer before? *

Yes

No

Are you looking for full-service interior design or just ideas/direction? *

Full-service

Ideas/Direction

On a scale of 1-3, how much do you want to be involved in the design process? *

1 - Not much, I trust you are the design expert and will follow your direction

2 - I have some ideas and want to be somewhat involved

3 - I want to be very involved and have definite ideas

Are you planning to purchase custom products through our firm or try to shop on your own? *

Purchase through your firm

Shop on my own

On a scale of 1-3, how important is quality when selecting your furnishings? *

1 - Not at all important, price is my main concern

2 - Somewhat important, I'm more interested with getting a good value

3 - Very important, I'm interested in high quality furnishings that are stylish and durable