As a long arm quilter, I try to find out what the customer is thinking--both design, thread choice, etc. Often they don't really have a clear design in mind--so I'll suggest a couple of designs. But first and foremost is finding out her price range--like most quilters, I charge more for hand quided vs. panto, dense quilting vs light meander/stipple.
Regarding panto--while I much prefer to work at the front of the machine and do hand guided/custom, sometimes a complex piecing quilt is best highlighted by a panto or edge to edge.