Shopping Preference Form

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This field is for validation purposes and should be left unchanged.

Consent(Required)

Filling out the information below will help shoppers meet your personal needs so your living space feels like home. What you will receive depends on the size of your household and the current availability of items in our warehouse. Bridging’s stock varies on a daily basis and we may not be able to meet your exact specifications. Please acknowledge you have read this paragraph.

I acknowledge I have read this statement.

Shopping Date(Required)

MM slash DD slash YYYY

Appointment Reference Number

Client Name(Required)

First Last

Preferred Name/Preferred Pronouns

Primary Language Spoken

Address(Required)

Street Address Address Line 2 City State ZIP Code

Additional Notes

Please indicate what floor you live on and unit number. Does your building have an elevator? Bridging will not deliver up more than 2 flights of stairs (including both interior and exterior stairs) without an elevator. Any additional information that would impact delivery.

Location of appointment

The location of your appointment is based on your address, your referring agency will assign you to the location of your appointment. Selecting your location will help us route your preference sheet to the correct team to assist you with selecting your items.

Phone(Required)

Alternate Phone #

How many people are in your household?(Required)

MUST enter household number in order to continue.

How many adults are in your household?

Color Preference (general)

Type favorite colors of members of household, if applicable.

Favorite colors; Children under 18

Type ages of children and favorite color, if applicable

Type of Home

Other: Describe Your Home

Beds

Bed Number 1(Required)

HH 1: 1 Bed any size (Bridging is unable to deliver king-sized beds)

Bed Number 2

HH 4-6: 2 bed any size + 1 Twin; (Bridging is unable to deliver king-sized beds)

Choose Bed Size

HH 7+: 3 bed any size + 1 Twin (Bridging is unable to deliver king-sized beds)

Consent

I understand Bridging does not deliver King-sized beds.

I will arrange pick up for my king-sized bed. Bridging does not deliver King-sized beds.

If first choice for bed is unavailable:

If first choice for bed is unavailable, what size bed would you prefer? (Bridging is unable to deliver king-sized beds)

Extra Twin Bed?

Households 2 or greater may be eligible for an extra twin mattress (no box spring), if available. Would you like this?

Yes

Declined (Do not need this item)

Dressers

Select the dresser style that you most prefer(Required)

Tall:

Wide:

Either

Decline (I do not need this item)

Wood Color

Dark

Light

Painted

No Preference

Upholstered Furniture: All items offered are based on availability.

Upholstered Furniture Choices – Household <5

Households of 4 or less people can choose seating for up to 5 people. (Couch = 3 seats, love seat = 2 seats, chair = 1 seat). Please choose which items you would like in your home to make up your total seating.

Couch

Love Seat

Upholstered Chair

Decline (I do not need these items)

Upholstered Furniture Choices (one seat per person)

Households of 5 or more can select one seat per person. (Couch = 3 seats, Love Seat = 2 seats, Chair = 1 seat.) Please choose which items you would like in your home to make up your total seating. NOTE: Please make your choices based on what will fit in your home.

Sectional

Couch

Love Seat

Upholstered Chair

Decline (I do not need these items)

Color/Pattern Preference

Check all that apply.

Dark Colors

Bright Colors

Light Colors

Floral

Geometric Designs

Plaid

Solid

Additional Preferences

Favorite colors or designs, if applicable.

Wood Furniture

Bridging’s stock varies on a daily basis, we may not have specific items at the time of your shopping appointment. All items offered are based on availability.

Wood Furniture Piece Number 1

Please rank your top five choices of items we often have available. You will receive 3-4 items, depending on household size. HH 1-3: 3 pieces HH 4+: 4 pieces

Wood Furniture Piece Number 2

Please rank your top five choices of items we often have available. You will receive 3-4 items, depending on household size. HH 1-3: 3 pieces HH 4+: 4 pieces

Wood Furniture Piece Number 3

Please rank your top five choices of items we often have available. You will receive 3-4 items, depending on household size. HH 1-3: 3 pieces HH 4+: 4 pieces

Wood Furniture Piece Number 4

Please rank your top five choices of items we often have available. You will receive 3-4 items, depending on household size. HH 1-3: 3 pieces HH 4+: 4 pieces

Book Shelf Shape

TV Stand Size

In order to choose a TV stand to fit your tv set, what size is the television you currently have?

Bonus Section: All items offered are based on availability.

Bridging’s stock varies on a daily basis, we may not have specific items at the time of your shopping appointment. All items offered are based on availability.

Bonus Item: 1st Choice

You may receive up to five miscellaneous items. These are the types of items we sometimes have in stock. Rate your 1st choice.

Bonus Item: 2nd Choice

You may receive up to five miscellaneous items. These are the types of items we sometimes have in stock. Rate your 1st choice.

Bonus Item: 3rd Choice

You may receive up to five miscellaneous items. These are the types of items we sometimes have in stock. Rate your 1st choice.

Bonus Item: 4th Choice

You may receive up to five miscellaneous items. These are the types of items we sometimes have in stock. Rate your 1st choice.

Bonus Item: 5th Choice

You may receive up to five miscellaneous items. These are the types of items we sometimes have in stock. Rate your 1st choice.

Bar Stool Height

Bar height: 29-32″ from floor to seat Counter height: 23-28″ from floor to seat

Dining/Kitchen Table

Dining Table Size(Required)

1 per household

Big (Seats 5+)

Medium (Seats 3-4)

Small (Seats 1-2)

Decline

Dining Table Shape

Square

Rectangle

Circle or Oval

Flat on one side (for fitting against a wall)

Dining Table Color Preference

Dark

Light

Painted

No Preference

Number of Kitchen Chairs

(one seat per member of HH)

Number of Kitchen Chairs

HH of more than 4 can choose kitchen chairs per person in household.

Small Appliances

Bridging’s stock varies on a daily basis, we may not have specific items at the time of your shopping appointment. All items offered are based on availability.

Small Appliances – 1st Choice(Required)