New Customer Questionnaire
Here is a new customer questionnaire. This questionnaire enables us to understand your landscape needs, likes and dislikes. Please consider each question carefully to enable us to build your outdoor environment to your liking.
* Your information will remain confidential and will not be sold or given away in any way.
Customer Contact Information:
Name:
Email Address:
Address 1:
Address 2:
City, State, Zip:
Phone Number:
Convenient time to contact you:
Your position in landscape decision (owner, contractor ...)
Design Description
Please check the type of property to be landscaped: (check 1)
Residential Commercial building Park Industry
Design Preferences
Purpose of Landscape Project: (check all that apply)
Provide more shade Provide more privacy
Provide a noise filter Provide a windbreak
Provide for more sunlight Add more fragrance
Growing fruits/vegetables Attract birds
Attract butterflies Attract wildlife
Solve parking problems naturally Improve landscape through windows
Solve a drainage problem
Other: (Please specify below)
Landscape Mood: (check all that apply)
Relaxing Private Bright/Cheerful Green
Social Structured/organized Meditative
Goals for the landscape project: (5-7 lines)
Enter your favorite colors:
Enter your favorite plants/shrubs:
Time(s) of day the area would be appreciated/used:
Favorite season(s):
Landscape Theme: (check all that apply)
Year round interest Ornamental Woody Colorful
Perennials Simple Symmetrical Bordered
Symbolic Sculpture Fen shui Lawn beauty
Landscape Style: (check one)
Formal Informal Natural Geometric Curves
Uniqueness Strait lines
Landscape Area prospected uses: (check all that apply)
Relaxing Reading area
Casual dining Play area
Hanging laundry Growing Fruits/Vegetables
Formal entertainment Social gathering
Compost soil area Sunbathing
Other(s): (Please specify below)
Hardscape Elements/Materials available now: (Check all that apply)
patio hot tub planters parking shed
arbor concrete stairs/steps garden walls gazebo
gravel boulders fence clothesline stones
pond stream fountain statues greenhouse
pool barbecue compost deck rockscape
trelace swing set outdoor play equipment
other: (Please specify below)
Hardscape Elements/Materials you wish to add to your project :
(Check all that apply)
Users of the landscaped area: (check all that apply)
Children 0 - 12 years old Teenagers Adults Dogs
Number of people viewing landscaped area on a daily basis: 1 2 3 4 5 6 7 8 +
Time that will be spent in the landscaped area:
Less than an hour/week 1 - 5 hours/week 5 - 10 hours/week
11 - 24 hours/week 25 + hours
Drainage Solution
Does your property have a drainage problem? Yes No
If applicable, the problem with drainage on the property is:
Actual Landscape Installation
Who are you planning on installing your landscape?
Jurgens Landscape Owner Outside contractor N/A
What is the approximate budget for this project: $
When is a good time to start designing the project:
January Febuary March April May June July August September October November December
When is a good time to start construction on the project:
Late March April May June July August September
Maintenance Preferences
Amount of time worked in the yard:
Off season: hours/week Peak Season: hours/week
How often are the grounds maintained?
1 a week 2 times a month 3 times a month Once a month Once every season Area is not maintained
Final Comments/Questions
Please include any comments you have regarding your landscape design/construction that was not discussed in this survey. Also feel free to include any questions you have. Please tell us what your needs are and how you envision your project at completion.
How did you find out about Jurgens Designed Landscapes?
Please press submit to submit the survey, but CAUTION: pressing reset will clear the form blank.