Lotus Home Solutions
Cleaning Service Checklist
Personal Information
Name
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Residential Information
Type a question
*
House
Apartment
Townhome
Mobile Home
Other
Square Footage:
*
Bedrooms
*
Bathrooms
*
Occupants
Pets
*
Rooms to be Cleaned
*
Bedrooms
Bathrooms
Kitchen
Living Room
Dining Room
Utility Room
Office/Den
Game Room
Nursery
Other
Areas not to touch:
Additional Services (extra fee):
Change/Make beds
Oven interior
Refrigerator interior
Deep clean of cupboard fronts
Cupboard interiors
Drawer interiors
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Service Information
Type of Cleaning(s)
*
Deep/Spring Cleaning
Standard/Maintenance Cleaning
Move In/Out
Service Frequency:
*
Monthly
Tri-Weekly
Bi-Weekly
Weekly
Occasional
One-Time
Preferred Day of Service:
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
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How did you find us?
(Facebook, Nextdoor, Google, etc.)
Please verify that you are human
*
Signature
*
How would you rate this experience?
1
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4
5
Your opinion matters to us :)
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