Name Phone Date Jan Feb Mar April May Jun July Aug Sept Oct Nov Dec 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2005 2006 2007 2008 2009

Address City State Zip

General Information

1. How did you learn about H&S Cabinets and Construction?

2. When would you like to start your project?

3. What budget range have you established for your kitchen? It is important to give yourself a budget.
This does not mean our estimate will reflect what your budget is. It only verifies that you are interested and have given thought to
budgeting for your project. It has been my professional experience that most of my clients will budget similar to the cost of their
automobile. The same thing applies to a kitchen or bath remodel. Do want a generic model or one with all the luxuries?

4. Do you have a specific Builder/Contractor? Yes No

5. Do you intend to retain an Interior Decorator or Architect? Yes No

6. What do you like about your present bathroom?

7. What do you dislike about your present bathroom?

8. Is this a master , children's , or guest bath project?

9. How many bathrooms are in your home? 1 2 3 4+

10. Who will use the bathroom?

11. Have you considered privacy zoning to allow several users to occupy the space at one time? Yes No

12. Do you prefer separate showering and bathing areas? Yes No

13. Would you like to consider either a tub or shower that will accommodate more than one person? Yes No

14. Do you prefer that the toilet be separated from the other fixtures, and placed in its own space? Yes No

15. What appliances do you plan on using in the bathroom?

Design Information

16. What type of feeling would you like your new bathroom space to have?

Strictly Functional Sleek/Contemporary Traditional Other (Specify)

17. What colors do you like? and dislike?

18. How important is it to you that the bathroom flows to adjacent spaces, from a design similarity standpoint? Not Sure Not At All Somewhat Very

19. Have you made a sketch or collected pictures of ideas for your new bathroom? Yes No

20. General expression of your new bathroom feeling:

Storage Checklist

21. Hamper Facility Yes No Medicine Storage Yes No Bath Linen Storage Yes No

22. Specific number of drawers required

Project Specifications

23. Cabinetry: Wood (Specify) Painted Laminate Polyester/RTF Other Specify

Door Style:

Hardware/Hinges:

Exterior Finish/Color:

24. Countertops: Corian (Solid Surface) Granite Marble Ceramic Tile Wood Laminate

Backsplash Height:

25. Bath Fixtures: (Note: We do not supply fixtures, unless you would like us to include Kohler standard fixtures. We do include installation of all fixtures you purchase.)

Toilet Model & Color:

Toilet Seat Model & Color:

Tub Model & Color:

Lav(s) Style & Color:

Lav Faucet(s) Type/Spread:

Tub Valve Model:

Tub/Shower Valve Model:

Shower Head Model:

Tub Drain/Overflow Parts:

26. Tub Surround Material & Height:

27. Shower Wall Material & Height:

28. Shower Pan Material:

29. Accessories: Bench Footrest Soap Dish Shampoo Caddy

30. Ventilation: Fan Fan/Light Combo Fan/Light/Heat Combo Switch Timer

31. Tub or Shower Enclosures: By Other

32. Light Fixtures: Incandescent Florescent Halogen

33. Windows: Existing New Specify Type:

34. Doors: Existing New Specify Type:

35. Flooring: By Other; however, we can include a quote for ceramic tile if requested:

36. Paint & Wallpaper: By Other: