Your name:
Mailing Address:
City:
State:
Zip:

Phone:
Email:

Franchise Location Nearest You:

Budget:

under $5,000
$5,000-$10,000
$10,000-$25,000
$25,000-$50,000
$50,000-$100,000
$100,000-$150,000
$150,000-$250,000
over $250,000

Tell Us About Yourself - To Help Us Guide
Your Design:
What is your design style? Contemporary? Traditional? Eclectic?
Type of Project: New construction
  Remodel
Project Start Date/Month
Project End Date/Month

Desired Outcome:
A whole new look - Remodel throughout
Updates and refurbishment
I need more storage
I need a multi-use space including storage and display
Other - Describe

Family Info:

# in family:
Ages:
Pets:

Are there special needs to consider? Explain.

Click on the Room Types below to fill out the Design Questionnaire.
Do not be overwhelmed by the length of the form. You may fill out as much or as little as you like!
Select the Submit Form button when complete.
 

Styles of Dining:
Formal
Informal

Entertain Frequently?
Yes
No

Eating Area in the Kitchen?
Yes
No
Primary Cook:
Height:
Right handed
Left handed
Secondary Cook:
Height :
Right handed
Left handed

Cabinetry Style:   
View Cabinet Samples

If you chose "I want to mix it up" please explain below:

Cabinetry Type:

Cabinetry Hardware:

Cabinetry Wood Species:

Finish Enhancements (& color):

Painted Finish-Color
Spattering
Distressing
Glazing
Highlighting

Countertops:

Icestone (recycled glass and concrete) 
Paperstone, Richlite (recycled paper) 
EcoTop (recycled fiber and bamboo)
Eco by Cosentino
Tiling
Vetrazzo (recylced glass)
Sandhill (recycled glass)
TerraGreen (recycled glass and porcelain)
Crossville (recycled glass and porcelain)
Fireclay (construction debris tiles)
Wood
Verdicrete (sealed concrete)

Backsplash:

Floors (choose all that apply):  View 7 Flooring Samples
Tiling
Marmoleum
Cor-Terra(recylced rubber and cork)
FSC certified hardwood
Bamboo
Reclaimed wood
Glass Tiles
Porcelain Tiles (recycled content)
Other (explain below)

 

Building Materials (choose all that apply):
Insulation
Radiant floor heating
Insulated window shades
Metering device
Renewable energy systems
Ventilation and heat exchange/Heat recovery systems
FSC certified plywoods and bamboo plywoods

Lighting:
LED bulbs
CFL bulbs (for Floods, Dimmables, Exterior, Under Cabinet, Specialty Bulbs)
Fixtures (engineered for CFL and LED bulbs)
Under cabinet lighting

Painting:

Check off items you want to have specialized
storage or display space for:

Baking sheets
Breadboard
Bulk items
Computer/printer
Cookbooks
Cutlery
Flatware
Oversized pots/pans
Pet food/supplies
Phone chargers
Waste basket
Towels
Wine
Plates/cups		 Recycling
School supplies
Serving items
Small appliances(list below)

Spices
Sponges
Stand mixer
Stemware
Other (explain below)

Additional Wish List Items:

Desired Look or Function:

Description of Item:

Notes or Comment:

Family Room/Media Room/Craft Room/Laundry and Utility

Floors (choose all that apply): View Flooring Samples
Hardwood Floors - FSC Certified
Bamboo
Reclaimed Wood
Cork Tiling
Carpeting: Wall to Wall, Wool Carpet Tiles
FLOR Carpet Tiles
Area Rugs: Bound Wool, Linen, Seagrass
Marmoleum
Cor-Terra(recylced rubber and cork)
Porcelain Tiles (recycled content)
Other (explain below)

Building Materials (choose all that apply):
Insulation
Radiant floor heating
Insulated window shades
Metering device
Renewable energy systems
Ventilation and heat exchange/Heat recovery systems
FSC certified plywoods and bamboo plywoods

Lighting:
LED bulbs
CFL bulbs (for Floods, Dimmables, Exterior, Under Cabinet, Specialty Bulbs)
Fixtures (engineered for CFL and LED bulbs)

Painting:

Fireplace (if it applies):

Furniture:

Upholstery/Reupholstery
Sofas
Chairs
Tables
Coffee Table, Side Tables
Lighting Fixtures

Area Rugs:

Designer Selections
Custom
Bound

Window Treatments:

Shades - Roman, Roll-up, Panels 
Shades/Drapes - Custom
Thermal Screens
Insulated Shades

Cabinetry Style:

If you chose "I want to mix it up" please explain below:

Cabinetry Type:

Cabinetry Hardware:

Cabinetry Wood Species:

Finish Enhancements (& color):

Painted Finish-Color
Spattering
Distressing
Glazing
Highlighting

Family Room/Media Room "wish" List:

Board games
Books/magazines
CDs/DVDs
Collectibles
Computar/printer
Game console/games
Throw pillows/blankets
Toys

Appliances-
Coffee maker
Microwave
Mini fridge/drawer
Other(explain below)

Office/Craft Room "wish" List:

Books/magazines
CDs/DVDs
Collectibles
Computar/printer
Craft supplies
Gift wrapping items
Office supplies
Art supplies

Appliances-
Coffee maker
Microwave
Mini fridge/drawer
Other(explain below)

Check off items you want to have
specialized storage or display space for:

Backpack/school supplies
Broom/dustpan
Bulk items
Cleaning supplies
Coats/hats/gloves
Gardening items
Hangers
Household tools
Ironing board/iron
Laundry supplies
Pet food/supplies
Recycling center
Seasonal items
Sewing/repair kit
Shoes/boots
Soiled laundry
Sports equipment
Steamer
Towels
Vacuum cleaner
Waste basket
Other

Additional Wish List Items:

Desired Look or Function:

Description of Item:

Notes or Comment:

Floors (choose all that apply):

Hardwood - FSC certified hardwood
Bamboo
Reclaimed wood
Cork Tiling
Carpeting: Wall to wall, wool carpet tiles
FLOR carpet tiles
Area Rugs: Bound wool, linen, seagrass
Marmoleum
Cor-Terra(recylced rubber and cork)
Porcelain Tiles (recycled content)
Other (explain below)

 

Building Materials (choose all that apply):
Insulation
Radiant floor heating
Insulated window shades
Metering device
Renewable energy systems
Ventilation and heat exchange/Heat recovery systems
FSC certified plywoods and bamboo plywoods

Lighting:
LED bulbs
CFL bulbs (for Floods, Dimmables, Exterior, Under Cabinet, Specialty Bulbs)
Fixtures (engineered for CFL and LED bulbs)

Painting:

Fireplace (if it applies):

Furniture:

Upholstery/Reupholstery
Sofas
Chairs
Tables
Coffee Table, Side tables
Lighting Fixtures

Area Rugs:

Designer selections
Custom
Bound

Window Treatments:

Shades - Roman, Roll-up, Panels 
Shades/Drapes - Custom
Thermal Screens
Insulated Shades

Check off items you want to have specialized
storage or display space for:

Closet/dressing:

Accessories
Boots
Formal wear
Linens
Luggage
Seasonal items

Appliances:

Clothes washer/dryer
Coffee maker
Ironing board/iron
Microwave
Mini fridge
Steamer
Other:

Additional Wish List Items:

Desired Look or Function:

Description of Item:

Notes or Comment:

Specify Quantities:

Vanity:    Sinks:
Toilet:   Tub:
Shower:      

Floors (choose all that apply):
Tiles
     Sandhill (recycled glass)
     Fireclay(construction debris tiles)
     TerraGreen(recycled glass & porcelain)
     Crossville (recycled glass & porcelain)
Marmoleum
ECO-Terr
Hardwood Flooring
     FSC certified hardwood
     Bamboo
     Reclaimed wood

Other (explain below)

 

Showers:

Icestone (recycled glass and concrete)
Tiling
     Sandhill (recycled glass)
     Fireclay (construction debris tiles)
     TerraGreen (recycled glass and porcelain)
     Crossville(recycled glass and porcelain)
Mix (specify)
Other (specify)
ECO-Terr

Vanity Tops:

Icestone (recycled glass and concrete) 
Paperstone, Richlite (recycled paper) 
EcoTop (recycled fiber and bamboo)
Eco by Cosentino
Tiling
Vetrazzo (recylced glass)
Sandhill (recycled glass)
TerraGreen (recycled glass and porcelain)
Crossville (recycled glass and porcelain)
Fireclay (construction debris tiles)
Wood
Verdicrete (sealed concrete)

Vanity Top Type:

Backsplash:

Lighting:
LED bulbs
CFL bulbs (for Floods, Dimmables, Exterior, Under Cabinet, Specialty Bulbs)
Fixtures (engineered for CFL and LED bulbs)

Cabinetry Style:

If you chose "I want to mix it up" please explain below:

Cabinetry Type:

Cabinetry Hardware:

Cabinetry Wood Species:

Cabinet Finish Enhancements (& color):

Painted Finish-Color
Spattering
Distressing
Glazing
Highlighting

Painting / Cabinets:

Painting / Walls:

Building Materials (choose all that apply):
Insulation
Radiant floor heating
Insulated window shades
Metering device
Renewable energy systems
Ventilation and heat exchange/Heat recovery systems
FSC certified plywoods and bamboo plywoods

Check off items you want to have specialized
storage or display space for:

Bulk paper items
Cleaning supplies
Cosmetics
Soiled laundry
Waste basket
Shelves
Table
Towels
Other (explain below)

Additional Wish List Items:

Any Spa Features -Describe:

Desired Look or Function:

Description of Item:

Notes or Comment:

Boston Metro Area
218 Lincoln Street
Allston, MA 02134
Tel: 617-314-9484
metrosouth@ggreendesign.com