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* 1. First and Last Name and phone number

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* 2. Which services are you interested in?

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* 3. What design areas are you interested in?

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* 4. Approximately how many total square feet for your entire project?

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* 5. What is your ideal time frame for starting the project?

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* 6. Do you need the project to be completed by a certain date?

Date

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* 7. Is there anything else about your project that you'd like us to know? Your vision, ideas, needs for the space?

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* 8. I would describe my style as...

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* 9. I like colors that are...

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* 10. My total project investment level is:

T