Name Email Address Address Address 2 City/Town State/Province - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle EastArmed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederate States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming ZIP/Postal Code Phone Number How did you hear about us? How did you hear about us? - Select -Google searchSocial media (Facebook, Instagram, etc)ReferralShowroomBest Picks ReportsHouzzHome AdvisorAngie's ListManufacturer/VendorLBK Work TruckHouse & Home MagOther… Enter other… Who referred you? How many people live in your household? - None -12345678910 Who cooks in the family? How does a secondary cook help out? How often do you casually entertain in a year? - None -OnceTwice3 times4 times5 times6 times7 times8 or more times How often do you formally entertain in a year? - None -OnceTwice3 times4 times5 times6 times7 times8 or more times Where are your evening meals served? How often do you buy groceries? How often do you buy groceries? - None -WeeklyDailyBuy in bulkOther… Enter other… How long do you plan on staying in this home? How long do you plan on staying in this home? - None -1 - 5 years5 -10 years10 or more yearsOther… Enter other… How long have you been contemplating a kitchen remodel? How long have you been contemplating a kitchen remodel? - None -1- 5 years5 - 10 years10 or more yearsOther… Enter other… Are there any other home improvement projects that you are considering? Current Kitchen Issues Please select all that apply. Problem Areas Odd layout Limited cabinet space Limited counter space Limited lighting Wall(s) removal needed Other… Enter other… Appliances Needed Please select all that apply. Refrigerator - None -Top freezerSide-by-sideFrench door/Bottom freezerWood paneled Dish Washer - None -StandardPaneled Oven - None -SingleDoubleMicrowave/Oven combo Microwave - None -Over rangeBaseDrawer Cooktop/Range cooktop - None -GasElectricInductionDowndrafthood Range - None -GasElectricInduction Hood - None -WoodStainless Must-Haves For New Kitchen Please select all that apply. Kitchen options Island Second prep sink Mullion or glass doors Open shelving Multi-level counter shelves Trash/recycling cabinet Bar area Wine fridge Cookbook storage Pet area Trash compactor Garbage Disposal Desk/workstation area Undercounter lighting Counters & Backsplash Counter top material Granite Quartz Laminate Soap Stone Stainless Steel Wood/Butcher Block Marble Backsplash should Match the counter Remain simply painted wall surface Wood bead board Ceramic, stone, metal tile Glass Unsure Styling Favorite colors Favorite fixture finish Your Interior / Home Styling - None -Modern ( Mid-Century)ContemporaryTraditionalColonialTransitionalFrench CountryIndustrialVictorianShabby ChicCoastal/BeachRusticCraftsmanFarmhouseEclecticCottageSouthwesternArt DecoMediterraneanUnsure Wish List All of your wish list What budget do you have in mind for your kitchen? - Select -$30,000 - $50,000$50,000 - $65,000$65,000 - $80,000$80,000 - $100,000$100,000 - $150,000$150,000 - $200,000$200,000 - $300,000Budget not listed When do you plan to begin your project? When do you want to have your project completed?