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Surveys
2017
January
B
Blissful Designs
Blissful Designs
0%
Exit Survey
Hello: You are invited to participate in our client survey Intake Form. Potential clients will be asked to complete a survey that asks questions about design preferences. It will take approximately 5 - 10 minutes to complete the questionnaire. Your participation in this assessment is completely voluntary. There are no foreseeable risks associated with this project. However, if you feel uncomfortable answering any questions, you can withdraw from the survey at any point. It is very important for us to learn your opinions and preference. Your survey responses will be strictly confidential and data from this research will be reported only in the aggregate. Your information will be coded and will remain confidential. If you have questions at any time about the survey or the procedures, you may contact Kaneisha Page at 571-216-0997 or by email at
[email protected]
. Thank you very much for your time and support. Please start with the survey now by clicking (
I Agree)
box below.
I Agree
*
Do you reside in an Apt or house?
Apt
House
*
Do you have hardwood or carpet?
Hardwood
Carpet
*
Decor Theme (Please Select One)?
-- Select --
Pure White
Neutral/ Traditional
Exotic / Vibrant Color
Rustic / Industrial
Elegant / Sleek chic
*
What room would you like serviced (Select all that apply)?
Living / Family Room
Nursery / Kids Room
Dining Room
Bedroom
Bathroom
Other
Preference for the following:
Very Preferrable
Suitable
Not Preferable
*
Paint (Colors)
*
Area Rugs
*
Window Treatment
*
Storage
Preferable Accent Furniture:
Wall Art
Accent Table
Storage Ottaman
Floor Mirror
Lighting
*
Not At All
*
Neutral
*
Must Have
*
Do you have a Budget?
$100 - $500
$500 - $1,200
$1,200 - $5,000
Contact Information
*
First Name
:
*
Last Name
:
*
Phone
:
*
Email Address
:
Additional Comments/Suggestions:
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