(Please print and mail to: Knapp Schmidt Architects, PO 762, Wautoma, WI 54982 or fax to: 920-787-1418)
BUSINESS
AND BUILDING OVERVIEW
Contact Information:
Date:________________________
Name:________________________
Street Address:_________________
City:__________________________
State:_________________________
Zip:___________________________
Is this address a home or business address?:___________
Telephone:____________________ Home / Business (circle one)
Can we call this number during business hours?:_____
Do you have a preferred time you would like us tocall?:______
Fax:__________________________ Home / Business (circle one)
Do we need to call before sending a fax?:______
Email:_________________________
Tell
us about your business:
Business Name:_____________________
New or Existing Practice:______________
Practice Type:
_____Small Animal Hospital
_____Mixed Practice Animal Hospital
_____Large Animal Hospital
_____Boarding Facility
_____Animal Shelter
Services you intend to offer:
_____ Medical Care
_____ Boarding
_____ Dog Day Care
_____ Grooming
_____ Retail
_____ Adoption
_____ Other (please specify):
Tell us about your proposed building:
Which of these conditions match yours?:
_____ Construct a New Building
_____ Alter or Add to the Existing Business Building
_____ Alter or Add to a vacant Existing Building
_____ Alter a Tenant Space (interior only)
_____ Not Sure
To
help calculate the size of the building:
Animal Hospital:
Number of Doctors:_______
Number of Exam Rooms:______
Number of Dog Kennel Runs:________
Boarding/Daycare Facility
Number of Dog Kennel Runs:______
Indoor Exercise Room?:______
Animal Shelter
Number of Dogs:______
Number of Cats:_______
Other Species:________
Animal Control Services?:_______
Please tell us any additional details about your practice and proposed project that you think are important:
Knapp Schmidt Architects Services you are interested in:
_____Architecture/Design
_____Market Study/Income Projection
_____Feasibility Analysis
_____Financing Options
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