Name:* |
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Address: |
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City/Township: |
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State: |
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Zip Code: |
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Daytime Phone:* |
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Evening Phone: |
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Cellular Phone: |
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Best Time To Call: |
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E-Mail:* |
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When Do You Plan To Remodel? |
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Do You Have Another Bathroom To Use
During Remodeling ? |
Yes
No |
Do You Have A Set Of Plans? |
Yes
No |
What Size Area Are You Considering
Remodeling ? |
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What is your approximate budget? |
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Will You Be Replacing The Toilet ? |
Yes
No |
Will You Be Replacing The Cabinets
? |
Yes
No |
Will You Be Replacing The Shower ? |
Yes
No |
Will You Be Replacing The Tub ? |
Yes
No |
Will You Be Replacing The Faucets
? |
Yes
No |
Will There Be Tile Work To Be Done
? |
Yes
No |
Will The Fixtures Be Remaining In
The Same Locations? |
Yes
No |
Would you like us to call you? |
Yes
No |
Comments or
questions:
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