COLVIN KITCHEN AND BATH

Bath Questionnaire

BATHROOM PLANNING QUESTIONNAIRE

The answers you give to the following questions will help your designer plan a bathroom that will better fit your needs. It also gives you an opportunity to consider the options that you have available to you.

Please print this form out and complete it prior to our first meeting so that we can review it together.

Circle which bathroom you are remodeling

Master Bath

Guest Bath

Half Bath

1. What is the main reason for wanting to remodel your bathroom?

_____________________________________________________________________

2. How many people use the bathroom at the same time? __________

3. How many bathrooms are in your home? ___________

4. Approximately how old is your house? ___________

5. Is the bathroom located on the: First Floor / Second Floor / Basement

6. Is the bathroom located over a: Basement / Crawl Space / Slab

7. Is there a second floor, attic or open area above it? _____________

8. Are the bathroom walls drywall or plaster? ____________________

9. What type of heating system do you have? ____________________

10. Is anyone who will use this bathroom physically challenged? _______

11. If so, is this person confined to a wheelchair? __________________

12. Do you have a style preference: Country / Traditional / Contemporary

13. What color do you have in mind for the main fixtures? ___________

14. Would you like the vanity to be taller? ______________

15. Would you like more storage space if possible? ________________

16. Do you have a preference of countertop materials:

Solid Surface, Cultured Marble, or Laminate

17. What items are you planning on replacing?

___ Bathtub ___ Vanity ___ Flooring ___ Wallpaper

___ Lighting ___ Toilet ___ Countertop ___ Window

___ Exhaust Fan

18. Are there any special items or needs that you would like to have this bathroom accommodate?

___ Whirlpool bathtub for one ___ Whirlpool bathtub for two

___ A larger shower ___ A shower with multiple shower heads

___ Steam shower ___ Bench in shower ___ Taller Vanity

___ Polished brass faucets ____ Brushed chrome faucets

____ Lever handle faucets ___ Heated ceramic tile floor

___ Comfort height toilet ___ Handicap accessible

___ Safety bars Other _______________________________

19. Are you having any problems with your existing bathtub, toilet or sink draining slow? _______

20. If so please describe the problem. ___________________________

21. Do you have low water pressure at any of the fixtures? __________

22. If so please describe. ______________________________________

23. Does your existing toilet flush properly? _____________________

24. How long have you been thinking about this project? ___________

25. Is there a date that this project must be completed by? ___________

26. If so, when? _________________________

27. Have you considered a budget for this project? (on average a complete bathroom remodel where we pull and replace the existing fixtures will cost $9,000.00-$12,000.00, depending on materials selected. A major project with whirlpool tub, multi-head shower system, relocation of fixtures etc. can exceed $20,000.00)

My budget range for this project is $_______________________

28. Last question - Do you remember how you first heard of Colvin Bathroom Remodeling?

___ Yellow Pages ___ Radio ___ Television ___ Mail

___ Trucks ___ Showroom ___ Referral ___ Repeat Customer

___ Home Show ___ Newspaper ___ Other

Your cooperation in filling out this form is greatly appreciated. Your answers will allow us to tailor our proposal to meet your needs in a more personalized manor. Please have this form completed and ready for us to discuss at our scheduled meeting.

COMPLETE KITCHEN & BATHROOM REMODELING FROM DESIGN TO FINAL DUSTING

Colvin Kitchen & Bath 1314 East State Blvd. Fort Wayne IN 46805 Ph:260-471-2284 E-Mail: Bathman007@aol.com