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Your Name
E-Mail Address
Phone Number
Street
Suburb/City State Postcode
Age 18-2930-4950-6970+
Budget $300k -$399k$400k-$499k$500k-$599k$600k-$699k$700k-$799k>$800k
Style of Home Unit villa (eg 2-5 units on the one block)House and Land package: (land, house and fully landscaped)House only: Build a house / unit on your landDemolish existing home and build a new homePart of a special purpose apartment complex
Number of bedrooms 1234>4
Number of bathrooms 12>2
Size Block Small (less than 500m2)Medium (500m2 to less than 800m2)Large (800m2 or more)
When are you wanting to buy or build? As soon as possibleWithin the next 12 months1-2 Years3-5 Years5+ Years
Specialised storage requirments gardening equipment (lawn mower etc)collections (eg wine, craft)large book casesspecific furniture (eg antique sideboard)display cabinetsfiling cabinetstoolspianospace to keep campervan / boat / trailerother
Specific hobbies woodworkvegie gardeninglibraryspare room (eg craft, art studio, music, gym, office)other
Guest room fold down bed yesno
Pet Requirements area to wash/groom dogchicken coopother
Does anyone in your home have any access requirements? yesno
What Lifetime Homes features would you like to incorporate?
Spacious doorways, hallways and garages yesnomaybe
Level access with no steps yesnomaybe
Spacious kitchen yesnomaybe
Specific appliances yesnomaybe
Kitchen benches that can be lowered for wheelchair access yesnomaybe
Specially designed bathrooms (eg plywood in walls to attach grab rails either now or in future) yesnomaybe
Removable shower panel installed (so later can use for wheelchair access) yesnomaybe
Lever door hardware yesnomaybe
Larger lightswitches yesnomaybe
Do you have an occupational therapist? yesno
Any other specific requirements or comments?
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