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Wide Back Fabric
Batting
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Quilt Intake Form
Customer Information
Name*
Phone
Email*
Address
Date Received
Date Needed
Quilt Information
Quilt Name/Description
Quilt Top Size (in) – Width
Quilt Top Size (in) – Height
Top Orientation – Top Marked
Top Orientation – Please Indicate
Backing Provided
Yes
No
Backing Type
Pieced
One-piece
Extra Wide
Size of Backing – Width (in)
Size of Backing – Height (in)
Is Backing Seamed Straight?
Yes
No
Batting Provided
Yes
No
Batting Type
Shop Batting
Cotton
Poly
Blend
Wool
Other
Shop Batting – Other
Quilting Design
Quilting Type
Edge-to-Edge
Custom
Semi-Custom
Design Name/Style
Density Preference
Light
Medium
Heavy
Thread Top Color
Bobbin Color
Thread Brand/Type
Additional Services
Trim Quilt
Bind Quilt
Machine Front
Machine/Hand Finish
Full Binding
Square Up Quilt
Repair Seams / Fix Minor Issues
Special Instructions or Notes
Pricing Estimate
Quilting – Rate (per sq. in)
Quilting – Amount
Batting – Amount
Thread – Amount
Binding – Amount
Other – Amount
Total Estimate
Quilter’s Notes (Internal)
Backing square and ironed
Yes
No
Top pressed
Yes
No
Thread chosen
Pattern used
Date quilted
Signatures
Customer Signature (type name)
Customer Signature – Date
Quilter Signature (type name)
Quilter Signature – Date
Submit
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