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:

Family members:

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 ___

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+

Where does your family eat its meals?

___Kitchen ___ Dining Room ___ Other: ____________________

Where will your family eat after you remodel/build?

___Kitchen ___ Dining Room ___ Other: ____________________

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

What other activities will take place in your new kitchen?

___Laundry  ___Homework ___Watching TV

___Paying Bills  ___Sewing  ___Computer Center

___Other:  _______________________________

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

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

Who is the primary cook?  ________________________

Is the primary cook

___Left Handed or ___Right Handed?

How tall is the primary cook?  _________________--

What is the primary cook’s cooking style?

___Gourmet Meals ___Family Meals

___Quick & Simple Meals ___Baking

___Bringing Meals Home

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.

Does the primary cook have any physical limitations?

___Yes ___No

Is there a secondary cook?

___Yes ___No

If there is a secondary cook are they

___Left handed or ___Right handed

How tall is the secondary cook?  ___________________

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

What are the secondary cook’s responsibilities?

___Prepare side dishes  ___Clean up

___Assist in preparing main course

Does the secondary cook have any physical limitations?

___Yes ___No What type? __________________________________

Design and Style

What are your color preferences for your new kitchen?  __________________________

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

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

___Yes ___No

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

___Yes ___No

What do you like about your current kitchen?

What do you dislike about your current kitchen?

Do you require a recycling center in your kitchen?

___Yes ___No

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

Will you be keeping your existing appliances?

Dishwasher: ___Existing ___New

Refrigerator: ___Existing ___New

Oven/Range:  ___Existing ___New

Microwave:  ___Existing ___New

What is your style preference for your new kitchen:

___Contemporary ___Formal ___Country ___Traditional

Time and Budget:

When would you like to begin your project?  _________________________

When would you like your project completed?  ________________________

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

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

General Information:

Name:

Address:

City/State/Zip:

Home Phone:

Work Phone:

Fax:

New Home Address:

City/State/Zip:

Builder Name (if applicable):

Contact Name:

Phone:

Fax:

Architect Name (if applicable):

Contact Name:

Phone:

Fax:

Interior Designer Name (if applicable):