Valley Kitchen Sales & Service, Inc. - Mt. Pleasant, PA - Kitchen and Bath Design, Remodeling, and Cabinetry

Valley Kitchen

Sales & Service , Inc.


		KITCHEN DESIGN SURVEY FORM (click here for .pdf)

Name:	_________	_________	_________	_________	_________	_________
Address:	_________	_________	_________	_________	_________	_________
City:	_________	_________	_________	_________	_________	_________
State:	_________	_________
Zip:	_________	_________

Phone:	_________	_________

Date:	_________	_________


GENERAL CLIENT INFORMATION

1. How long have you lived at, or how much time do you spend at the jobsite residence?

2. When was the house built?_________				How old is the present kitchen?__________

3. How did you learn about our firm?_____________________________________________________________

4. When would you like to start the project?_______________________________________________________

5. When would you like the project completed?____________________________________________________

6. Has anyone assited you in preparing a design for the kitchen?______________________________________

7. Do you plan on retaining an interior designer or architect to assist you in the kitchen planning?___________

8. Do you have a specific builder/contractor or other subcontractor/specialist with whom you would like to work with?
___________________________________________________________________________________________
9. What portion of the project, if any, will be your responsibility?_______________________________________

10. What budget range have you established for your kitchen project?__________________________________

11. How long do you intend to own this residence?__________________________________________________

12. What are your plans regarding this home?______________________________________________________
	a. Is it a long or short term investment?__________________________________________________
	b. Is return on investment a primary concern?_____________________________________________
	c. Do you plan on renting this residence in the future?______________________________________

13. What family members will share in the final decision0making process?______________________________
___________________________________________________________________________________________

14. Would you like our firm to assist you in securing project financing?_________________________________

15. What do you dislike most about your present kitchen?___________________________________________
___________________________________________________________________________________________

16. What do you like about your present kitchen?__________________________________________________
___________________________________________________________________________________________


SPECIFIC KITCHEN QUESTIONS

1. How many household members? (and approximate ages)
	_________	Adults	_________	Teens	________	Children	________	Other
	_________	Pets		What types?____________________________________________

2. Are you planning on enlarging your family while living here?______________________

3. Who is the primary cook?______________________
Is the primary cook left-handed?________ or right-handed?_____________
How tall is the primary cook?_____________________________________
Does the primary cook have any physical limitations?_________________

4. How many other household members cook?_____________________________________________________
Who are they?_____________________________________________________________________________
Do they have a cooking hobby_________, assist the primary cook with a specific task__________________,
or share a menu item with the primary cook?____________________________________________________
Is the secondary cook(s) right-handed____________, or left-handed?________________________________
How tall is the secondary cook(s)?_________________________________
Is a specialized cooking center required for the secondary cook(s)?_________________________________
Do they have physical limitations?____________________________________________________________

5. How does the family use the kitchen?_________________________________________________________
	________ Daily Heat & Serve Meals				_________Daily Full-Course, "From Scratch" Meals
	_________Weekend Quantity Cooking				_________ Weekend Family Meals
Other____________________________________________________________________________________

6. Is the kitchen a socializing space?____________________________________________________________

7. How would you like the new kitchen to relate to adjacent rooms?___________________________________
________________________________________________________________________________________
________________________________________________________________________________________

	_________ Family Room				_________ Dining Room
	_________ Family Home Office				_________ Family TV Viewing

8. What time of day is the kitchen used most frequently?____________________________________________

9. What are your kitchen and dining area requests?_________________________________________________

	_________ Separate Table				_________ 30" Table Height Dining Counter
	_________ New ________Existing				_________ 36" Counter Height
	_________ Size _______Leaf Extension				_________ 42" Elevated Bar Height Dining Center
	_________ Number of Seated Diners

10. Do you do any specialty cooking?______________Gourmet _________Canning ________Ethnic

11. Do you cook in bulk for freezing___________ and/or leftovers?_____________

12. Do you entertain frequently?__________Formally ____________Informally

SPECIFIC KITCHEN QUESTIONS (cont'd)

13. Designing the kitchen so that it shpports your entertainment style is part of the planning process. Tell us which
statement fits you the best:
_______ I like to be the only one in the kitchen with my guests in a separate space that is away from the kitchen
_______ I like to be the only cook in the kitchen, with my guests close by in a family room space that opens onto
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 in meal preparation
_______ I like my guests to help in the cleanup 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 and pick up the food
	_______ I stop at the deli/take-out restaurant to bring part of all of the meal home before entertaining
	The items that I purchase from outside sorces are:
	_______ Appetizers		_______ Salads		_______ Soups
	_______ Entrees		_______ Desserts		_______ Other

14. What secondary activities will take place in your kitchen?
	_______ Computer			_______ Laundry			_______ TV/Radio
	_______Eating			_______ Planning Desk			_______ Wet Bar
	_______ Growing Plants			_______ Sewing			_______ Other
	_______ Hobbies			_______ Study			_______ Other

15. What is your cycle of shopping for food?
	_______ Weekly		_______ Bi-weekly			_______ Daily

16. What types of products/materials do you purchase at the grocery store?
Predominantly fresh food purchased for a specific meal____________________________________________
Predominantly frozen foods purchase for stock___________________________________________________
Traditional pantry boxed/packaged/canned goods purchased for stock________________________________
	(1) Types of canned goods:
	______ Condiments _______ Fruits _______Soft Drinks _______ Vegetables
	(2) Cleaning products stocked in bulk___________________________________________________
	(3) Paper products stocked in bulk_____________________________________________________
	(4) Other boxed/packaged food items stocked in bulk______________________________________
	(5) Other__________________________________________________________________________


SPECIFIC KITCHEN QUESTIONS (cont'd)

17. Where do you presently store:
	_______ Baking Equipment			_______ Non-Refrigerated			_______ Spices
	_______ Boxed Goods			Fruits/Vegs.			_______ Table/Appointments
	_______ Canned Goods			_______ Paper Products			_______ Linens
	_______ Cleaning Supplies			_______ Pet Food			_______ Wrapping Materials
	_______ Dishes			_______ Pots & Pans			_______ Leftover Containers
	_______ Glassware			_______ Recycle Containers			_______ Other
	_______ Laundry/Iron			_______ Specialty Cooking			_______ Other
	Equipment			Vessels (Wok, etc.)

	Legend:	B = Base Cabinet		C = Countertop			L = Laundry Room
		BA = Basement		AG = Appliance Garage			T = Tall Cabinet
		BC = Bookcase		D = Desk			W = Wall Cabinet

18. What type of specialized storage is desired?
	_______ Bottle			_______ Dishes			_______ Plastic
	_______ Bread Board			_______ Display Items			_______ Soft Drink Cans
	_______ Bread Box			_______ Glassware			_______ Spice
	_______ Cookbook			_______ Lids			_______ Vegetables
	_______ Cutlery			_______ Linen			_______ Wine
	_______ Other			_______ Other			_______ Other

19. What type of cabinet interior storage are you interested in?
	_______ Lazy Susan			_______ Roll-outs			_______ Drawer Ironing Board
	_______ Pantry			_______ Towel Bar			_______ Toe-Kick Step Stool
	_______ Vertical Dividers			_______ Tilt-out			_______ Other
	_______ Recycling/Waste Bins			_______ Drawer Head			_______ Other

20. What small specialtry electrical appliances do you use in your kitchen?
	_______ Blender			_______ Elec. Fry Pan			_______ Wok
	_______Can Opener			_______ Food Processor			_______ Other
	_______ Crock Pot			_______ Griddle			_______ Other
	_______ Coffee Pot			_______ Toaster			_______ Other

21. Have you considered relocating or changing the windows or doors in the new plan? __________
	_________________________________________________________________________

22. How do you plan on sorting recyclable trash in your new kitchen?
	Sorting Into:		________ Plastic			_________ Compact refuse
			________ Paper			_________ Trash
			________ Glass
				a.______ clear
				b.______ brown
				c.______ green

23. Would you like a sorting station in the:
	_______ kitchen		_______ utility room		_______ garage		_______ basement


DESIGN INFORMATION

1. What type of feeling would you like your new kitchen space to have?
	Sleek/Contemporary		________		Warm & Cozy Country			________
	Traditional		________		Open & Airy			________
	Strictly Formal		________		Formal			________
	Family Retreat		________		Personal Design Statement			________

2. What colors do you like____________________ and dislike_____________________________?

3. What colors are you considering for your new kitchen?__________________________________

4. What are color preferences of other family members?___________________________________

5. Have you made a sketch or collected pictures of your ideas for your new kitchen?____________

6. Design Notes:
_________________________________________________________________________________

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Valley Kitchen Sales & Service, Inc.

555 Valley Kitchen Drive

Mt. Pleasant, PA 15666

Phone: (724) 547-3557

Fax: (724) 547-5886

Email: info@valleykitchensales.com