of 15DEFINE. DESIGN. DELIGHT.

Kitchen & Bath Concepts’ Design Survey.

Distinctive designs for tasteful living.

of 15KBC DESIGNERSLead Designer

Associate Designer

CLIENT INFORMATIONName

Address

Project Address if Different

Phone

Email

PROJECT INFORMATIONType of project?

Have you purchased a kitchen in the past?

Have you collected images on any of these social media platforms? Select all that apply Instagram Web

Address:

HouzzWeb Address:

Pintrest Web Address:

1

Renovation New Construction

Yes No

OtherWeb Address:

of 15What type of feeling would you like your new kitchen to have?

Traditional

Transitional

Contemporary

Formal

Open & Airy

Warm & Cozy Country

Eclectic

Personal Design Statement

Other:

Traditional

Transitional

Contemporary

2

of 15Have you selected a color palette?

Please list colors do you like and dislike.

Has anyone assisted you in preparing a design for your kitchen?

Are you working with any of the following on your project?

When would you like to start the project?

When would you like it completed?

How much time will you spend at the residence?

Yes

Yes

No

No

I like:

Architect:

Builder:

Contractor:

Interior Designer:

Other:

I dislike:

3

of 15What budget range have you established for your new kitchen?

How much do you want to invest in your cabinetry?

Will other family members participate in the design and selection process?

What do you dislike most about your current kitchen?

What do you like most about it?

$40,000 – $60,000$60,000 – $75,000$75,000 – $100,000 $100,000 - $150,000$150,000 +

$20,000 – $40,000$40,000 – $60,000$60,000 – $75,000$75,000 – $100,000 $100,000 +

Yes No

4

of 15 Cabinetry supplied by environmentally

responsible manufactures

Countertops made from recycled materials

Energy Efficient Appliances

Sustainable design details incorporated into

the plan

Areas for recycling waste incorporated into

plan

Other:

Are environmentally friendly / sustainable products important to you?

If you are remodeling are you planning to expand your kitchen?

Are you considering relocating any of the following: What year was the house built?

How old is the kitchen?

If you are building a new home are you able to relocate doors?

Windows?

Are you able to relocate walls at this stage of construction?

Yes

Yes

Yes

Yes

Yes

Doors

No

No

No

No

No

Windows Walls

Somewhat

5

of 15

Feeding Area

Storage Area (Food, Treats, Litter Etc.)

Bedding/Crate Area

Other requests

Name Age Handed Height Physical Limitations /Mobility Aids

L

L

L

L

L

L

L

L

R

R

R

R

R

R

R

R

Household Members:

Family Pets?

Would you like to include a place for any of the fol-lowing in your new kitchen?

How does the family use the kitchen for meals?

Yes No

Daily heat and serve meals

Daily “from scratch” meals

Combination of the two

Weekend family meals

Weekend Quantity Cooking

6

of 15Is the kitchen a socializing space?

How would you like the new kitchen to relate to adjacent rooms?

What are your seating requirements in the kitchen and dining area?

Do you entertain regularly?

Separate Dining Table

Countertop Eating Area

36” Height

42” Bar Height

Formally

Informally

Both

Yes

Yes

No Infrequently

No

7

of 15When entertaining, which statement(s) fits you best?

What secondary activities take place in your kitchen?

I like to be the only one in the kitchen with my guests in a separate space.

I like to be the only one in the kitchen, with my guests in a space open to the kitchen.

I like my guests to be sitting in the kitchen visiting with me while I cook.

I like my guests to help me in the kitchen with meal preparation. I like my guests to help in the clean-up process after the meal.

I retain caterers who prepare all meals for entertaining.

The caterers come to the home to serve and cleanup.

I stop by the caterers/deli/restaurant and pick up the food.

Work/Homework

TV/Radio

Wet Bar

Hobbies

Laundry

Other

8

of 15Do you have a preference on faucets?

Are you considering any additional sink features?

One Handle with

Pull-Out Spray

Side Spray

No Spray

Two Handles with

Side Spray

Other

Soap Dispenser

Pedal Valve

Pneumatic Switch for Garbage Disposal

Filtered Water Dispenser with

Chilled Water

Hot Water

Carbonated

Yes

Yes

No

No

9

of 15What type of specialized storage is desired?

What small specialty electrical appliances do you use in your kitchen?

Cookbooks

TV/Radio

Cutlery

Glassware

Spices

Trays

Wine

Other

Electric Mixer

Crock Pot

Coffee Pot

Food Processor

Griddle

Toaster

Toaster Oven

Other

10

of 15Do you want a recycling station in your kitchen?

What is the typical pattern of cooking in your household?

How tall is the primary cook?

Does the primary cook have any cooking hobbies or specialty cooking preferences?

Combination Trash/Recycling

Separate Recycling Center

Yes No

One person does most of the cooking. Who is this?

Two or more people cook at the same time.

Other

Gourmet

Baking

Ethnic

Grilling

Bulk Cooking to Freeze

Other

11

of 15Does the primary cook have any physical limitation?

How many other household members cook?

Who are they?

Do they have a cooking hobby?

Is a specialized cooking center required for the secondary cook?

What about Clean Up?

Clean-up is done by someone other than the cook?

Do you have a cabinetry finish preference?

Yes

Yes

No

No

The cook cleans up.

Cleaning is shared by two or more people.

Who?

Stained

Painted

Stainless Steel

Other

12

of 15Do you have a particular stain or paint color in mind?

What type of countertop are you envisioning in your kitchen?

What type of backsplash are you envisioning in your kitchen?

Would you like assistance with a lighting/electrical plan?

Are you interested in decorative lighting (pendants, wall sconces, chandeliers, etc.) if it works with the design direction?

Are you planning on purchasing new appliances?

Yes

Yes

Yes

Yes

No

No

No

No

Granite

Quartz Product

Other

Ceramic Tile

Glass Tile

Other

Wood

Combination

Stone Tile

Glass Panels

13

of 15Are you planning on reusing existing appliances?

Do you have a preference regarding the style of the appliances?

Do you have a preference regarding the kitchen sink(s)?

Do you have a preference regarding the material of your kitchen sink(s)?

Yes No

Stainless Steel Professional Series

Decorative Front Panels to hide ap-pliances

Stainless Steel Contemporary Styling Other

Single

Double

Galley

Other

Stainless Steel

Porcelain

Cast Iron

Other Decorative Finish

14

of 15Is there anything else you would like us to know about your dream kitchen or the way you plan use it?

Finally, in an effort to assist our beleaguered marketing guy, how did you learn about Kitchen & Bath Concepts?

Thank you for taking the time to complete our survey. This will assist us when designing your perfect kitchen!

Please save this completed survey and email it back to us. Thanks!

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