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Optical Dispensary Design Questionnaire
General Information
Today's Date:* Fax Number:
Practice Name:* Website:
Client Name:* Email Address:*
Street Address:* Type of Practice:
Address 2: Timeline:
City:* Building Type:
State:* Total Sq. Ft:*
Zip Code:* Dispensing Sq. Ft:*
Phone (Main):* Project Type:*
New Office Existing Office
Phone (Cell): Financing:*
Yes No
Dispensing Information
Number of Frames:
High-end Mid-end Low-end Yes No Not Sure
Men's: Lockable Displays:
Women's: Children's Area:
Children's: Reception/Waiting Area:
Sunglasses: Total Number of Frames:
Number of Dispensing Tables:
Client Type: Professionals Upper Middle Low Income
Display & Furniture Budget: Under $10k $10k-$15k $15k-$20k Above $20k
Decor Preference: Ultra Modern Modern Traditional Hybrid
Number of Dispensing Tables:
Additional Notes:
Floor Plan Upload If you have a digital floorplan and/or images of your store in JPEG, PNG or PDF formats, please upload them here to help us better serve your design needs.
Image Upload:
Image Upload:
Image Upload:
*denotes required field
Terms & Conditions
Designs are created free of charge including four hours of design work and 3 basic revisions/changes to the same design. If more than four hours of design work and/or more than 3 revisions are required or a new floor plan is given, customer may be asked for a good faith deposit. All designs are copyrighted property of CNS Frame Displays and cannot be shared with any other vendors and/or suppliers. CNS Frame Displays will present the designs to the client via an online presentation tool, but the design files will not be sent to the client. An electronic copy of the completed design can be emailed to the client once a $300 good faith deposit is made by the client. This deposit can be applied towards future purchases. The right to use the design will be transferred to the client when all or a significant part of incorporated products in the design are purchased, or the $300 deposit is made. Please call CNS Frame Displays if you have any questions.