CONFIDENTIAL QUESTIONNAIRE PERTAINING TO REAL ESTATE NEEDS

This short questionnaire is designed to help you focus on just what is really important to you in a property, including establishing a maximum budget figure. The questions are based on the criteria we have found to be the most important to folks planning to retire and/or establish a leisure or full time home on Virginia’s Eastern Shore. We use this information to do a search of both the Eastern Shore Multiple Listing Service (MLS) and our own property database so that we can send you information only on properties which specifically meet your needs.

This questionnaire has helped us serve the many customers who have purchased property here through our firm. All information will be held strictly within our firm. We do not give out or sell your information to others and we will not spam you.

*Select for more information

	Please put me on your email list for properties which meet my requirements.
	I would like to receive a hard copy of your catalogue.
	Please do not send me anything.

*Name

Spouse

Street Address

City

State

Zip

Telephone Number

Work Number

Cell Phone

*Email

Select

	Retirement Home
	Primary Home
	Leisure Home
	Investment

Select

	Now
	6 Months
	1 Year
	3 Years
	5 Years or more
	Need to sell other property first
	We would like to come as soon as possible for a property tour

Select One

	$50,000-$100,000
	$100,000-$150,000
	$150,000-$200,000
	$200,000-$250,000
	$250,000-$350,000
	$350,000-$500,000
	$500,000-$1,000,000
	Over $1,000,000

Select One

	$150,000-$200,000
	$200,000-$250,000
	$250,000-$300,000
	$300,000-400,000
	$400,000-$500,000
	$500,000-$750,000
	$750,000-$1,000,000
	Over $1,000,000

Check all appropriate boxes

	Beach
	Boating
	Golf
	In-Town
	Farmette/Country
	Other
	Will only consider being directly on the water
	In waterfront community with easy access to water is fine
	Being on or near water is not important
	Existing home
	Buy land now (build now or later)
	Consider either

If Other, please list

Select One

	Under .5 acre
	.5 acre to 1 acre
	Prefer 1-3 acres
	Prefer 3-5 acres
	5-10 acres
	10-20
	Over 20

If Over 20, please specify

Select

	Free-standing Home
	Town Home or Duplex
	Condominium
	New Home
	Previously Occupied
	Older Home
	Historic
	Open to all

Select

	One story
	Two story
	Traditional
	Contemporary
	Transitional

Bedrooms

	2
	3
	4
	5 or more

Bathrooms

	2
	2 1/2
	3
	3 1/2
	4+

Special Needs:

	One floor living
	Low maintenance
	Home office

Select One

	Yes
	No

If Yes, Where?

	Florida
	Georgia
	South Carolina
	North Carolina
	Virginia
	Maryland
	Delaware
	Other

If Other, please specify

Check All Appropriate Boxes

	Beach
	Golf
	Tennis
	Swimming
	Fishing
	Hunting
	Boating
	Jogging
	Biking
	Kayaking
	Birding
	Horses
	Fitness
	Music
	Movies
	Fine Dining
	Plays
	Gardening
	Reading
	Pets
	Crafts
	Shopping
	Art
	Antiques

Blue Heron Realty Company is a local, family-owned real estate firm specializing in prime waterfront land and homes located on the Eastern Shore of Virginia, the Chesapeake Bay, and Cape Charles.