Bath Questionnaire First Name Last Name Address Home Phone Cell Phone Email How did you hear about us? Referral Drive By Print Advertisement Web Search From Who? From Where? Is your project New Construction Remodel When would you ideally like to start and complete the project? Desired start Date Date Desired completion date: What is your primary reason for the remodel? Resale Personal Needs How much do you feel comfortable spending on the project? Are you working with an Architect and/or Interior Designer? Yes No Interior Design Name Interior Designer Phone How long do you plan to live in the home that is being built/remodeled? How many people live in your home? Please provide names and ages below: Are there any physical limitations for anyone residing in your home? Yes No Please describe physical conditions Which bathroom(s) are you looking to remodel/design? (Please check all that apply.) Master Bathroom Hall/Family Bathroom Guest Bathroom Who will be the primary user of this bathroom? What are the heights of the primary users? How many bathrooms total are in your home? What do you like about your current bathroom? What don’t you like about your current bathroom? Are there any specific safety features you’d like to incorporate in your new design? If yes, please describe:
