Survey

Client Survey Form

1. Please Select a Style that best fits your personal taste.	Traditional Classic Contemporary European Eclectic Retro Metro Art Deco Other
2. What is the current interior design style of your home?	Traditional Classic Contemporary European Eclectic Retro Metro Art Deco Other
3. What is the architectural style of your home?	Tudor French Eclectic Colonial Contemporary Ranch Cape Cod Log Craftsman Bungalow /Prairie /Arts & Crafts Four Square Victorian European /Renaissance
4. Do you have plans to modify or expand the structure of your home?	Yes No
5. Where do you reside? (Street, city, state, zip)
6. What is your Budget (dollars)?	Less the 5K 5 - 10K 10 - 20K Over 20K
7. Have you ever worked with an Interior Designer before?	YES NO
7a. If yes, with whom did you work?
8. At what stage are you in the redesign process?	Considering options Planning Ready To Begin Urgent Desire To Begin
9. Would you like a Jaro Interiors Designer to contact you?	YES NO
Name:
Phone number:
Email Address:

free web form

Thank you for completing this questionnaire, it will help us determine your design needs.

what's your
style

see our work

Family House

Residential

Mortland

Dollhouse

Jaro Interiors, Inc., 3734 Poplar Avenue, Pittsburgh, PA 15234
(T) 412.561.5454 (F) 412.564.5474
www.jarointeriors.com - info
C 2007 Jaro Interiors, Inc.