Customer Intake Form
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
example@example.com
Phone Number
Please enter a valid phone number.
Date
-
Month
-
Day
Year
Date
What are your preferred color palettes for the walls?
Neutrals
Bold Colors
Pastels
Earth Tones
Other
Are there any specific colors you love or want to incorporate?
Blues
Greens
Yellows
Reds
Other
Are there any colors you dislike or want to avoid?
white
Black
Bright Colors
Dark Colors
Other
Do you have any existing furniture or decor that you want to coordinate with the new design?
Yes, it has neutral tones
Yes, it has bold colors
Yes, it has earthy tones
Yes, it has a mix of colors
Other
What mood do you want to create with your color choices?
Calm and Relaxing
Energetic and Vibrant
Warm and Cozy
Elegant and Sophisticated
Other
Would you prefer accent walls or a single color throughout the room?
Accent Walls
Single Color
Two-Tone Walls
Varied by Room
Other
Do you like the idea of incorporating patterns or textures in your wall colors?
Yes, Definitely
Maybe, in Moderation
Only in Certain Rooms
No, I Prefer Solid Colors
Other
What overall style do you envision for your home?
Modern
Traditional
Contemporary
Rustic
Other
Do you have a specific theme or inspiration in mind?
Coastal
Bohemian
Farmhouse
Minimalist
Other
What is your preferred furniture style?
Mid-Century Modern
Classic
Vintage
Eclectic
Other
Which of these design elements do you prefer?
Clean Lines
Ornate Details
Natural Materials
Mixed Textures
Other
Are there any particular pieces of furniture or decor items you must have?
A Statement Sofa
A Dining Table
Unique Art Pieces
Cozy Rugs
Other
Do you prefer an open or more sectioned layout?
Open Layout
Sectioned Layout
A Mix of Both
Depends on the Room
Other
Any Additional Requests or Notes:
Submit
Should be Empty: