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CLIENT QUESTIONNAIRE

First name*

Last name*

Email*

Phone

Country / State / Time Zone*

ROOM DETAILS

Type of Room (Great Room, Dining Room etc)

Ceiling Height*

Crown Molding Height

Base Molding Height*

Dimension: North Wall*

Dimensions: East Wall*

Dimensions: South Wall*

Dimensions: West Wall*

Exterior Door: Wall?*

Open Passage No Door: Wall?

Bay Window Wall and Window Width?

Flat Screen Wall and Screen Size?

Fireplace Width and Wall

Vaulted or Recessed Ceiling

Yes, Recessed

Yes, Vaulted

ADDITIONAL INFORMATION

The number of Adult Residents (2 max) and height of each adult.*

Do either/both resident(s) have physical limitations?

Yes

Details (optional)

Preferred Style

Modern

Traditional

Minimalist

Eclectic

Organic

Neutral/Non-Descript

IKEA

Professional

Tropical

Coastal

Industrial

Other

If other, please detail here.

YOUR SURROUNDINGS

What surroundings colors/shades give you the greatest peace?

Color(s) - Bright

Color(s) - Subdued

Metal(s) (i.e. silver, chrome, bronze etc)

Organic neutral surroundings (woodtones, foliage)

High contrast (i.e. b/w)

Choose your top three favorite colors/shades by name & number:

# 1

# 2

# 3

YOUR LIFE

Is your life in general.....

Busy & unpredictable

Interesting but slightly boring

Do you have indoor pets and are they permitted on the furniture?

UPLOADS

Upload images of your wall art, soft decor, furniture etc. you enjoy and would like to consider/continue using.

Upload Floor Plan w/dimensions showing doors, windows etc. Does not need to be drawn to scale but dimensions must be accurate. (See FAQ for example.)*

Client's Notes

Signature

Date

Month

Day

Year

License # 000395-07-2024

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