The answers you give to the following questions will help you and your designer plan a bathroom that will best 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 before our first meeting so that we can review it together.
 

Your Name:


Your Email:


Your Phone Number:


Which bathroom you are remodeling?
Choose Master Bath Guest Bath Family Bath 1/2 Bath

1. What is the main reason for wanting to remodel your bathroom?
Choose Too Small Outdated Needs Repair Need Disabled Solutions

2. How many people use the above bathroom at the same time?
Choose 1 2 3 4 5 6 or more

How many bathrooms are in your home? Choose 1 2 3 4 more than 4

4. Approximately how old is your house? Choose 1-5 Years 5-10 Years 10-20 Years 20-30 Years 30_Years_or_more

5. Is the bathroom located on the: Choose first_floor Second_floor Basement

6. Is the bathroom located over a: Choose basement crawlspace slab

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

8. Are the bathroom walls drywall or plaster? Choose drywall plaster

9. What type of heating system do you have?

10. Is anyone who will use this bathroom physically challenged? Choose yes no

11. If so, is this person confined to a wheelchair? Choose yes no

12. Do you have a style preference: Choose country traditional contemporary

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

14. Would you like the vanity to be taller? Choose yes no

15. Would you like to enlarge the bathroom?  Choose yes no

Would you like more storage space? Choose yes no

16. Do you have a preference of countertop materials: Choose solid cultured marble granite laminate

17. What items are you planning on replacing?

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

 

19. Are you having any problems with your existing bathtub, toilet or sink draining slow? Choose tub shower toliet sink draining slow

20. If so please describe the problem.

21. Are you having any problems with your tub leaking? Choose yes no

22. Do you have low water pressure at any of the fixtures? Choose yes no

23. If so please describe.

24. Does your existing toilet flush properly? Choose yes no

25. How long have you been thinking about this project? Choose a few days a few weeks a few months many months a year a few years many years

26. Is there a date that this project must be completed by? (if applicable )
Choose janurary februrary march april may june july august september october november december Choose 2007 2008 2009

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 $8,000.00-$12,000.00, depending on materials selected. A major project with whirlpool tub, multi-head shower system, relocation of fixtures etc. can exceed $15,000.00)

My budget range for this project is Choose $1000 $2000 $3000-$5000 $5000-$10,000 $10,000-$15,000 $15,000-$20,000 more than $20,000

28. Last question - Do you remember how you first heard of Sparklin’ Johns?
Choose 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.