2. Have you identified or thought about how to enlarge or change the space? If so, how? 

3. What aggravates you most when using this space? 

4. What pleases you the most when you use this space? 

5. Do you want more light by increasing window size/number or adding a skylight? 

6. Do you want more direct access to an adjacent room or exterior space? 

7. Do you want the space to feel larger by opening it up to an adjacent room? 

8. Do you want guests or family to visit with you while using this kitchen? 

9. Do you want an eating space within the kitchen? (Indicate what kind below) 

Just standing and eating is okay with a special area at 42" (bar height) above the finished floor. 
An informal eating bar with space for________stools at 36" (standard kitchen countertop height) 
or 42" above the floor. 
A more traditional table (fixed or movable) and space for_________chairs at 29" (standard table height ) above the floor. 
A custom upholstered booth in the corner with an attached table. Seat storage too. 
A flexible table size, with extensions is important Yes No

10. Does household traffic through the kitchen space bother you? 

Yes No 

11. Are there children in the home? Yes No 

Number of children: 

Ages of children: 

12. Do you want the children to help you in the kitchen? If so, doing what? 


13. Do you need a special place for children's activities? If so what kind? 

Doing homework Store toys/books Other 
Help with cooking Artwork area 
Play area Games 

14. Will there be a second or third cook or helper? If yes, how will they be helping? 

Washing veggies Using cooktop 
Washing dishes/cleanup Food prep/chopping, etc. 
Baking Other 

15. Any need for a special countertop height? (36" above the floor is considered standard and 33" above the floor can serve baking purposes better. Taller clients find that 38" high is more comfortable.) 

36" at all countertops Mixture of 36" and 38" 
38" high at all countertops I would like a countertop of 33" near: 

16. Do you or anyone in your family have back pain or need accommodation for another physical situation? 
Yes No 

If so, please describe anything that we can do to help. 

Raise dishwasher higher No range - it puts oven too low. 
Wall oven(s) at comfortable height Freezer below refrigerator 
Lowered cooking surface Undercounter refrigerator or freezer drawers 
Microwave at comfortable height Other: 

17. Where do you want to store small appliances? 

On the countertop in view In an appliance garage on the countertop out of view 
In an upper cabinet In a lower cabinet specially sized for them to fit. 
Near the breakfast table On a roll-out shelf next to the:____________________ 
Other locations:________________________________ 
There is a large, heavy portable appliance that I would use more, if it was easier to access. 
Special needs: 


18. Who is the primary cook?_________________________________________________ 

The primary cook uses the following appliances routinely: (Please list). 

Is there a second cook? Yes No 

Who is the second cook?_________________________________________________ 

The second cook uses the following appliances routinely: (Please list). 

Do you cook together at: The same time At different times 

19. Is anybody left-handed? If so, are there any needs or preferences for the left-handed person? 

Dishwasher left of sink Dishwasher right of sink 
Dishwasher location - no preference Other: 


20. How often do you entertain guests in your kitchen? Weekly 

Monthly 1 or twice a year 

On the average, how many do you entertain as guests in one evening? 1 to 2 

3 to 4 5 to 6 7 to 10 10 or more 

Do you want them to help with the cooking? Yes No 
Do you want them to stay out of the cooking area? Yes No 

21. Will this kitchen need any special preparation space for the following: 

Canning Make candy Dehydrate food Baking 
Make stock Make ice cream Make pasta Grilling 
Wok cooking Wet bar Dry bar Wines 
Other:___________________________________________________ 

22. If you recycle, please check any recycling storage needs you would like in your kitchen. 

Plastic bags Scrap paper Glass Cans 
Newsprint Magazines Returnable containers Compost 
Other:_________________________________________ 

Just make a location for one or two (check your choice) hauler-provided recycling tubs. 

One tub Two tubs 
Put a recycling center somewhere in the kitchen. Give me storage accessories that will make it easy. 
Don't bother, I will store recycling items in the garage or other area away from the kitchen. 
Other: 

23. Where do you want to store the kitchen garbage? 

Under the sink in my own container 
Provide me a container that will have a lid that opens up when I open the cabinet door. 
Put a wire rack on the back of the sink door that will hold a plastic or paper bag. 
Provide a dedicated lower cabinet that will have one or two tall plastic trash containers. Locate 
near the sink or:________________________________________________. 

24. Indicate any preferences you might have for major appliances. Indicate any special sizes, type of fuel (gas or electric) finish appearance, brand name or model number, or if you plan to re-use an older appliance. In some cases you may not yet know your preference and that's okay. 

REFRIGERATOR 

Subzero type (cabinet depth) With icemaker 
Side by side Freezer below 
Freezer above Separate freezer appliance 
Wine cooler Small snack refrigerator - under 
Separate icemaker appliance counter 
With wood panels to match cabinets 
Stainless steel front Color 
Other:__________________________________________ 


COOKING/BAKING 

Range (combo cook top and oven) Simple hood to match appliances 
Cook top Hood to match cabinets 
Single wall oven Eye-catching hood 
Double oven Downdraft venting 
Micro/oven combo Warming drawer 
Small microwave Warming shelf above cooking surface 
Large microwave Other:______________________________ 
Combo hood/microwave 
Appliance colors:___________________________________________ 
Stainless Steel 

25. Do you want to have a desk, phone or TV area in the kitchen? 

If yes, indicate preferences below: 

I want to sit down at a desktop area I want to just stand up at phone area 
I want space for a computer with some storage and no knee space 
Laptop 
Keyboard drawer Put the phone on the desktop 
Printer space Put the phone on the wall. 
Provide for dial-up or cable/DSL I have a cordless phone 
I want to include high tech, data, voice wiring Phone message machine in the project 
White board 
Message center Bulletin board 
Blackboard File storage (legal or regular size?) 
Bookshelf Locate TV so I can see it while I: 
Space for television ___________________________________ 
Full size computer 
Store CPU below countertop 
Need internet connection at desk 

26. What kind of primary sink? Any specific model numbers or name would be helpful. 

Single compartment Double sink Stainless steel 
Farm sink Triple sink Integral countertop and sink 
Cast iron Composite Self-rimming 
Mounted below the countertop With disposer Attached draining area 

27. What kind of second sink? 

Stainless steel Composite type 
Glazed, decorative clay or cast iron Special decorative metal sink 
Small - for washing vegetables Full size single sink 
With disposer Self-rimming 
Under counter mount Cast iron 

28. Faucets and Accessories ** 

Pull-out "Euro" type (faucet Double handles Single handle head pulls out as a sprayer) 
With side spray Water filter 
Soap or lotion dispenser Insta Hot Water Chiller 
Disposer Air switch to control disposer on deck 
Preferred metal finish or color: ________________________________ 
Preferred Brand:____________________________ 

** Indicate what accessories you would like at your primary sink and secondary sink with either 
"P" or "S", or both if applicable. 


29. Cabinets 

Other Wood Species:________________________________ 
Oak Cherry Hickory 
Pine Clear Alder 1/4 Sawn White Oak 
Clear Fir Painted Exotic Hardwood Veneer 
Stained dark Stained light color Thermofoil (plastic coating - looks painted - very durable)
Maple Natural, clear finish
Knotty Alder  Antiqued, worn look Lots of moldings/detail 
Laminate Some moldings and detail No molding or detail 
Traditional style 
Contemporary, modern style, with simple clean lines and details 
A mixture of painted/stained, different woods, colors, styles 
Cutting-edge styling, use unusual materials and finishes to fit my special desires 
I want my kitchen to be very special, whimsical and fun, and to be a real design winner 

30. Countertops 

Plastic laminate (Formica) Square counter edge Beveled edge 
Plastic laminate with metal or special edge Corian edge 
Ceramic tile Porcelain tile Granite tile 
Marble tile Slate or other natural stone Slab granite or other stone 
Wood Butcher block Stainless steel 
Copper Exotic wood top Other metal________________ 
Silestone, Caesar stone, Zodiac or other quartz-type, man-made stone 
Corian, Gibraltar or other man-made tops 
Concrete I have special items to embed in the concrete top 

31. Flooring 

I like the floor I have, install new kitchen over it 
No-wax vinyl or similar 
Marmoleum (may require finish application) 
Vinyl or linoleum tiles 
Special cut-in patterns or design 
Wood floor Oak Maple 
Wide plank Bamboo Other____________________________ 
Refinish my existing wood floor 
I would like an engineered, real, wood floor, that is many times more durable than site-finished 
wood floors (and no sanding dust) 
Tile floor Ceramic tile Porcelain tile 
Natural stone floor 

32. Lighting 

Recessed lights in ceiling is the look I want 
Surface mounted light fixtures 
Contemporary 
Period Style 
Hanging fixtures in some or all areas is what I like 
Soffit lighting over upper cabinets 
Task lighting over the countertop is highly recommended - if desired, please indicate type below: 
Florescent type Halogen type None 

33. Miscellaneous 

Is the existing space Cold in Winter Warm in Summer 

Are their noises from rooms nearby that you would like to reduce? 

Yes No 

What color preferences do you have? 

What style are you going for? 

Traditional Craftsman Transitional - between Traditional and 
Neo classic Contemporary Contemporary 
Restore my kitchen to original house style 
Other:___________________________________________________ 

34. Please note if there are any other concerns or needs: 

PRIORITY 

Of all the items you acknowledged above, or for any not mentioned, prioritize your three most important preferences. Please add any comments. 

1) 

2) 

3) 

Please attach any pictures, magazine cutouts or other information that helps to clearly communicate your vision, idea or need.