A questionnaire to provide Havertown Kitchen and Bath information that can be used to design a kitchen ideally suited to you and your family.  You can print this page or download the file.

Family and Lifestyle:

1. Family members:

2. Approximate ages of family members:

Children Age___  Age___ Sex ___ Age___ Sex ___ Age___ Sex ___ Age___ Sex ___

Adults Age___ Sex ___ Age___ Sex ___ Age___ Sex ___ Age___ Sex ___ Age___ Sex ___

3. How long do you plan on living in the home you are remodeling/building?

___1 to 5 yrs  ___ 6 to 10 yrs  ___11 to 20 yrs ___ 20+

4. Where does your family eat its meals?

___Kitchen ___ Dining Room ___ Other: ____________________

5. Where will your family eat after you remodel/build?

___Kitchen ___ Dining Room ___ Other: ____________________

6. Do you require a kitchen table or would you be willing to explore other options if a design could be improved?

___Required  ___Preferred, but open to other options  ___Not necessary

7. What other activities will take place in your new kitchen?

___Laundry  ___Homework ___Watching TV

___Paying Bills  ___Sewing  ___Computer Center

___Other:  _______________________________

8. After your remodel/build, will you entertain frequently?  ___Yes  ___No

If Yes, what is your entertaining style?  ___Formal  ___Informal

Do you have large or small gatherings?  ___Large or ___Small

Do your guests help you in the kitchen when you entertain? ___Yes ___No

9. How do you shop?

___For the week ___For each meal ___Buy non-perishable items in bulk  ___Buy in bulk and freeze what you buy in bulk, do you require storage in the kitchen for all or most of these items? ___Yes ___No

Cooking Style

1. Who is the primary cook?  ________________________

2. Is the primary cook

___Left Handed or ___Right Handed?

3. How tall is the primary cook?  _________________--

4. What is the primary cook’s cooking style?

___Gourmet Meals ___Family Meals

___Quick & Simple Meals ___Baking

___Bringing Meals Home

5. What does the primary cook prefer?

___No one else in the kitchen while preparing meals.  ___A helper in the kitchen while preparing meals.  ___Family or friends visiting during meal preparation.

6. Does the primary cook have any physical limitations?

___Yes ___No

7. Is there a secondary cook?

___Yes ___No

8. If there is a secondary cook are they

___Left handed or ___Right handed

9. How tall is the secondary cook?  ___________________

10. Do the primary and secondary cook prepare meals together?  ___Yes  ___No

11. What are the secondary cook’s responsibilities?

___Prepare side dishes  ___Clean up

___Assist in preparing main course

12. Does the secondary cook have any physical limitations?

___Yes ___No What type? __________________________________

Design and Style

1. What are your color preferences for your new kitchen?  __________________________

2. Which colors do you not want in your new kitchen?  _____________________________

3. Have you created a scrapbook of notes, photos, and ideas that you would like to use in your new kitchen?

___Yes ___No

4. If a design could be greatly improved, would you be willing to make structural changes? (i.e moving windows, doors, and walls)

___Yes ___No

5. What do you like about your current kitchen?

6. What do you dislike about your current kitchen?

7. Do you require a recycling center in your kitchen?

___Yes ___No

If yes, how many separate bins do you need for sorting items?  _____

8. Will you be keeping your existing appliances?

Dishwasher: ___Existing ___New

Refrigerator: ___Existing ___New

Oven/Range:  ___Existing ___New

Microwave:  ___Existing ___New

9. What is your style preference for your new kitchen:

___Contemporary ___Formal ___Country ___Traditional

Time and Budget:

1. When would you like to begin your project?  _________________________

2. When would you like your project completed?  ________________________

3. If you are building, is the kitchen in your contract? ___Yes ___No

4. Do you have a budget for this project?  ___Yes: $___________________ ___No

General Information:

1. Name:

2. Address:

3. City/State/Zip:

4. Home Phone:

5. Work Phone:

6. Fax:

7. New Home Address:

8. City/State/Zip:

9. Builder Name (if applicable):

10. Contact Name:

11. Phone:

12. Fax:

13. Architect Name (if applicable):

14. Contact Name:

15. Phone:

16. Fax:

17. Interior Designer Name (if applicable):