Tell us about yourself and your design goals by filling out this form. We consider this
information to be confidential and will not share it with anyone.
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| Name |
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| Address |
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| City |
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| State |
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| Zip |
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| Home Phone |
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| Business Phone |
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| Mobile Phone |
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| Email Address |
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| Family Members (first names & ages) |
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| Pets |
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| Hobbies / Recreational Activities (Describe) |
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| General Color Preferences |
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| General Style Preferences (Traditional, Contemporary,
Victorian, etc.) |
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| General Wood / Metal / Fabric Preferences (Oak, Maple,
Iron, Brass, Silk, Plaid, Stripes, etc.) |
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| Window Treatments (What are you looking for?) |
Draperies?
Yes
No
Blinds?
Yes
No
Shutters?
Yes
No
Fabric?
Yes
No
Woods?
Yes
No
Any unusually shaped windows?
Yes
No
Any hard to reach windows?
Yes
No
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| Do you have these House Issues? |
Direct Sun?
Yes
No
Heat?
Yes
No
View?
Yes
No
Privacy?
Yes
No
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| This home or office is |
New
Existing
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| Area / rooms to be furnished (Describe) |
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| Furnishings being kept (Describe) |
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| Ambiance of specific room / rooms (Casual, Formal,
Romantic, etc.) |
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| What would you like this project to accomplish? |
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| What is your anticipated budget for this project? |
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| Special considerations? (Fragile accessories /
furniture, damaged wall / floor, etc.) |
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| I prefer to be contacted in the |
Morning
Afternoon
Evening
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| I prefer to be contacted on |
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
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| Directions to my home |
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| Any additional comments |
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Click button ONCE to Send Form |
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