Square Payment Form QHA

Business Payment Form

Order Details
Your Name

First Name Last Name
Your Email
example@example.com
Billing Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Is shipping address same as billing address?

Yes No
Shipping Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Special Instructions / Details

QHA Products (Tick box to select)

QHA CLEAN Certified Quality Assurance of Clean Standards attained. Certificate and Logo included. Credential issued per location.

$ 349.99 CAD Quantity

QHA CLEAN Verified Third Party Credibility. Quality Assurance of CLEAN standards with site visit Verification. (Final Price maybe influenced by exact site visit location)

$ 499.99 CAD Quantity

EQR (Emotional Quality Response) Assessment Quality assessment of emotional connection of your business to the client. Smart businesses today are looking to improve client trust and connection during these uncertain times.

$ 399.99 CAD Quantity

Custom Quality Assurance Assessments Open to discussion on whatever your company needs from Brand Standard reviews, Standard Operating Protocol updates to other areas of need. Pricing TBD upon project details.

Free

Total

$ 0.00 CAD

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Date	Postal Code

Should be Empty:

Business Payment Form