Healthy Home Design + Build Intake Form

Thank you for your interest in working with SENERGY360. This form helps us understand your project goals, site conditions, and priorities so we can determine the best path forward.

1. Client Information

Full NameEmail AddressPhone Number

Preferred Method of Contact

PhoneEmailText

2. Project Overview

Project Location (City, State)

Project Type

New ConstructionRemodel / RenovationBuild-Back (post damage or mold)

Do you plan to use SENERGY360 for:

Full Design + BuildNot sure yet

3. Project Goals (Priorities)

Select all that apply — what are the most important outcomes for your home?

5. Budget Range

To align expectations early, please select your anticipated investment range.

Anticipated Investment Range

$750K – $1.5M$1.5M – $2.5M$2.5M – $4M$4M+

7. Timeline

When would you like to begin design?Desired construction start dateIs there a required completion date?

9. Experience & Expectations

Have you built or remodeled a home before?

YesNo

What concerns do you have about the building process?

10. Health & Environmental Considerations

Are there specific concerns you want addressed?

11. Qualifying Question

What prompted you to reach out to SENERGY360?

12. Additional Notes

Anything else you would like us to know about your project?