Luxury Ultra Modern Custom Home Designs | Contemporary House Plans | Pre-designed Stock Plans
Custom Home Design
If you're not ready to complete the Client Requirements Form below and would like to just have a brief communication about your new project, click here to go to our (brief) free consultation form.
A Message from the Designer:

Dear prospective client,

Completing this form does not imply any commitment on your part. It just says that you're willing to take the time to express your needs and to begin a dialogue that could result in the design of a home that will bring many years of comfort and happiness to you and your family. 

My holistic approach to residential design requires information about your family's needs and the proposed site for your new home. Complete this form by clicking the boxes and filling the appropriate fields. If you're uncertain about any information, just leave the field blank. Typically, completing this form would take five to ten minutes of your time.

When you're through, press the 'Submit Form' button below and you will see a 'Form Confirmation' notice. This means that the form has already been submitted to us. After we review your completed form, we will contact you to discuss our design approach to your new home.

Cynthia Leif, AIA
Contact Info
First Name 
Last Name 
Street Address 
Postal/Zip Code 
Daytime Phone No. 
Home Phone Work Phone
Best Time To Call You
Fax No. 
Where did you  hear about us? 
If Others/Referred, please specify:
Which "search term" brought you to our site?
Lot Info 
Location of Existing Lot 
Lot Area   sq. ft.
Lot Dimensions   frontage x depth
Lot Slope   degrees
Lot Orientation 
Corner Lot?  Yes No
Irregular Lot?  Yes No
If YES, please fax a copy of your lot plan
Neighboring Structures 
Desired View Direction 
When do you want to start the Design Phase?
Target Date for 
Start of Construction 
Architectural Style:  Please select
Modern/ Ultra Modern
Not Sure yet
Other: (please specify)
Front Porch  Yes No
Foyer  Yes No
Living Room  Yes No

Combined with Dining Room

Is Living Room separate from the Great Room?


Dining Room  Yes No
Number of persons 

Additional informal dining area
Great Room  Yes No
Accessible to which rooms:
Den/ Music Rm  Yes No
Toilet and Bath   or: Powder Room
Entertainment Center
Office or Library  Yes No
Toilet and Bath      or:    Powder Room  
Built-in shelves
Guest Room  Yes No
Guest Room located at:
Ground Floor Second Floor Both
Toilet and Bath
Walk-In Closet
Kitchen  Yes No
Breakfast Nook
Open Plan    
Enclosed Kitchen
Island Counter
Kitchen Appliances
Laundry Room  Yes No
Built-in shelves
Located at:
Ground Floor  Second Floor
Ironing Area Comments
Servants' Quarter  Yes No
Access from Inside
Access from Outside
Both Toilet & Bath: Common Individual
No. of Employees per Room
Carport/Garage  Yes No
Open Carport Covered Garage
No. of Cars
Lanai  Yes No
Open Covered Screened With Trellis
Master Bedroom  Yes No
Walk-In Closet:
Yes No His and Hers Combined walk-in
Toilet and Bath: Yes No
Enclosed Commode: Yes No
Separate Shower Stall: Yes No
Bathtub: Yes No
Jacuzzi: Yes No
Children's Rooms  Yes No
Number of Rooms:
Walk-In Closet: Yes No
Toilet and Bath:
Private T & B Common/ Adjoining T & B None
Number of Children per Room:
Storage Room  Yes No
Size: Large Small None
Attic Studio  Yes No
Built-In Closet: Yes No
Toilet and Bath: Yes No
Access from which room?
Basement  Yes No
Built-In Closet: Yes No
Toilet and Bath: Yes No
Access from which room?
Balcony  Yes No
Open Covered  With Trellis
Roof Deck  Yes No
Outdoor Amenities  Swimming Pool
Diving Pool
Lap Pool
Game Pool None
Max. Depth  in feet
Length  in feet
Width    in feet
Lanai at Pool edge: Yes No
Shower Room/Cabana: Yes No
Gazebo Yes No
Property Fencing  Yes No
Type of Fencing:
Ornamental Only
Ornamental with Security
Landscaping Yes No
Air-conditioning  Yes No


Other Comments e.g. What your new home will mean to you and your family, What are the things that you don't like in your current house, What are the additional features that you want for your new home, etc. (your comments here help us understand your vision for your new home)

Total Floor Area you wish to achieve:

*(between _____sq.ft. to _____sq.ft.)

Approximate budget for house construction

Email: Email:
©2014 ULTRAMODERNHOMES.COM. All Rights Reserved