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Questionnaire
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Name:
*
Name:
First Name
Last Name
Email Address:
*
Phone:
Phone:
(###)
###
####
Address:
Address:
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Which Room[s] to be Designed:
*
Bathroom
Bedroom
Breakfast Room
Dining Room
Entry
Family Room
Hallway
Home Office
Junior Room
Kitchen
Living Room
Master Bedroom
Nursery
Play Room
Powder Room
Do you Rent or Own your Home?
Rent
Own
What Architectural Style is your Home?
Please Select
Art Deco
Cape Cod
Craftsman
Contemporary
Colonial
Cottage
Greek Revival
Mediterranean
Modern
Prairie
Ranch
Spanish
Townhouse
Victorian
What's your design inspiration? Share your Pinterest or Houzz links here.
http://
Does the Room[s] need to be kid or pet friendly:
Yes
No
If Yes, please explain.
Please give a brief description of your Family (including all members of the household):
How would you describe your style?
Please Select
Contemporary
Eclectic
Hollywood Regency
Modern
Nautical Coastal
Rustic
Traditional
Transitional
Shabby Chic
Vintage Retro
What is your favorite way to Entertain?
Casual
Formal
Colors you are drawn to?
Please Select
Warm Colors: Reds, Browns, Gold, Orange
Cool Colors: Blues, Greens, Silver, Grays
Neutral & White
Bold & Dramatic
Pastels
What Colors do you LIKE and want to see in the Room[s]:
What Colors and Styles do you NOT like:
Are you more drawn to Patterns or Solids?
Choosing Pattern[s]:
Argyle
Chevron
Damask
Floral
Geometric
Houndstooth
Ikat
Moroccan
Paisley
Plaid
Polka Dots
Scroll
Stripes
What is your preferred Metal Finish?
Please Select
Bronze
Brushed
Chrome
Gold
Silver
What is your preferred Wood Finish?
Please Select
White
Antique White
Light Oak
Natural Pine
Hickory Medium Brown
Cherry Red
Mahogany Dark Red
Dark Espresso
Grey Oak
Weathered Grey
Black
How would you like the Room[s] to feel?
Please Select
Peaceful
Bold
Cheerful
Cozy
Modern
Neutral
Romantic
Warm
Whimsical
Sophisticated
List furniture and accessories you would need or like to purchase for the Room[s]:
List existing furniture and accessories in the Room[s]:
Overall Design goals & needs:
What is the Budget for your Room[s]:
Exclusive Buying Opportunities:
All items will be sourced through Retail or Online stores available to the general public. If interested, we can shop "Trade Only" options and provide it at a discounted price off retail.
Yes, I am interested.
No, thank you.
List some Details that are important to you:
Do you have any special items you would like to display or include in the Design:
List stores you like to shop for furniture and accessories:
Additional Info:
Promo Code:
I agree to the Terms & Conditions for the E-Design Services?
*
Yes
No
Thank you! You are one step closer to transforming your space!