Services Form

Contact Information:
Name:

First NameLast Name
E-mail:
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number:

Area CodePhone Number
Birthday:
How did you hear about us today?
Household Information:
Children In The Home:

None0-4y/o5-12y/o13y/o+
Pets in the home:

YesNo
Lifestyle:
Entertaining lifestyle:

CasualFormal
Hobbies and Activities:
Colors you're most attracted to:

NeutralsCool Tones (Blues/Greens)Warm Tones (Reds/Oranges)
Colors you don't care for:
Which of these best describes your style:

ModernModern FarmhouseTransitionalTraditionalUrbanRusticEclectic
Project Information:
Person(s) responsible for project decisions:
Project is to be done:

All at onceIn stagesWithin the next 3 monthsWithin the next 6 months to 1 year
Please check all of the rooms to be included in the project:

Whole HouseFamily RoomKitchenDining RoomEntry/FoyerBedroomsBathroomsOffice/StudyBasementKids' RoomsOther
What kind of enhancements are you considering? (please check all that apply)

FurnitureWindow TreatmentsAccessoriesLightingFlooringPaint/Finish SelectionsKitchen RemodelBathroom RemodelBasement RemodelWhole House RemodelNew House BuildOther
How involved do you wish to be in this project?

Very involved. I just need some initial guidance and will finish the project on my own.Involved. I'd like to work as a team with Black Dog Design House to complete my project.Minimally involved. We will mutually agree on an overall design and budget for this project, but Black Dog Design House is free to do their thing!Other
What is your budget for this project (including furniture, accessories, flooring, window treatments, etc)?

Less than $10,000$10,000-$25,000over $25,000
Please give a brief description of the project:
Décor Style
Houzz account:
Pinterest account:
Instagram account:
Where do you like to shop for furnishings & accessories?
Please arrange these design attributes in order of importance, 1 being the most important:
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Contact Information:

Household Information:

Lifestyle:

Project Information:

Décor Style