Client Intake Form
**IMPORTANT NOTICE: Please we are no longer accepting ICBC home making claims.**
Name
*
First Name
Last Name
Mobile Number
Alternate Phone Number
Spouse's Name (if applicable)
First Name
Last Name
Spouse's Contact Number (if applicable)
Email
*
example@example.com
Service Address
*
Street Address
Unit Number
City
Province
Postal / Zip Code
Apartment Complex/ Townhouse Name
Billing Address (if different from above)
Street Address
Unit Number
City
Province
Postal / Zip Code
Preferred Payment Method
*
Please Select
Electronic Funds Transfer
Credit Card
You agree to pay 50% deposit upfront prior to the day of my scheduled cleaning service.
*
Yes
No
How did you hear about us?
*
Please Select
Google search
Facebook
From a friend
Realtor
COVID Screening Questions
Basic Maintenance Cleaning Service Work Order (this is not a “deep clean”)
Preferred Service Date
*
-
Month
-
Day
Year
Date
Type of Service Required
*
Please Select
Move In
Move Out
Regular Clean
Deep Clean
Frequency Required
*
Please Select
One-Time (Move In/ Move Out)
First/ Deep Clean
Weekly
Bi-weekly
Monthly
How many levels of home do you have?
How many bedrooms do you have?
How many bathrooms do you have?
What is the approximate size of your house?
On a scale of 1 - 10, how cluttered is the place you need cleaned? (1 being not cluttered at all and 10 being very cluttered)
Have you had professional cleaning in your house before?
Yes
No
If yes, when was the last time you had the professional house cleaning?
Do you keep up with your home?
Yes
No
Means of Entry (keys, will someone be there upon entry)
*
Security or Alarm Code (if applicable)
Parking Available?
Special Instructions or Directions for Parking (if applicable)
Pets and how may are they? (if applicable)
Pet Name(s)
Are you health-compromised? If so, how will this affect our service in your home?
Allergies (if applicable, otherwise, please put N/A)
*
Preparing For Your Cleaning Service
Declutter for your cleaner: pick up toys, clothing, whatever else has found it’s way to your countertops, clear away dirty dishes and food messes. The less clutter you have around the easier it will be for your house cleaner to focus on the more important tasks.
Kitchen
Kitchen Basic Service
Stovetop
Microwave
Counters/appliances
Sink
Dusting
Floors
Spot clean cupboards
Bathroom
Bathroom Basic Service
Shower
Tub
Sink
Counters
Dust
Toilet
Floors
Master Bedroom
Master Bedroom Basic Service
Dusting furniture
Dusting baseboards
Dusting blinds
Straightening
Vacuuming
Childs / Spare Room #1
Childs / Spare Room #1 Basic Service
Dusting furniture
Dusting blinds
Straightening
Vacuuming
Childs / Spare Room #2
Childs / Spare Room #2 Basic Service
Dusting furniture
Dusting blinds
Straightening
Vacuuming
Living / Family / Rec Room
Living / Family / Rec Room Basic Service
Dusting furniture
Dusting blinds
Straightening
Vacuuming
Wash floors
Home Office
Home Office Basic Service
Dusting furniture
Dusting blinds
Straightening
Vacuuming
Wash floors
Laundry/ Utility Room
Laundry/ Utility Basic Service
Dust
Wipe washer/ dryer
Vacuum floor
Entry
Entry Basic Service
Straighten
Dust/ vacuum/ wash floors
Others
Special Requests
Additional Comments/Notes
Kindly attach photos of the areas that you require cleaning
Browse Files
Drag and drop files here
Choose a file
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of
Kitchen
Kitchen Basic
Dusting
Wipe down cupboard doors
Wipe tables
Clean outside of appliances
Wipe countertops
Clean sinks and faucets
Shake or vacuum rugs
Take out trash (contained in a plastic bag)
Vacuum and wash floor
Clean glass sliding door
Disinfection of all high touch points
As Needed
Wipe backsplash
Clean main viewing windows
Clean glass sliding door
Clean window above sink
Bathroom
Bathroom Basic
Wipe the sink and counter
Clean mirror
Dust blinds
Clean Bathtub
Clean shower
Clean toilet
Empty trash: bathrooms and bedrooms (contained in a plastic bag)
Shake or vacuum rugs
Vacuum, wash floor
Disinfection of all high touch points
Deep Clean
Wash trash can
Wash windows
Wash window tracks
Wash baseboards
Wash behind toilet/walls
Wash walls and doors
Clean light fixtures (within reach)
Clean ceiling fan (within reach)
Bedroom
Bedroom Basic
Dust blinds
Straighten/ dust nightstands
Straighten/ dust dressers
Clean mirrors
Make bed
Vacuum
Wash floor
Disinfection of all high touch points
Deep Clean
Clean doors
Wash blinds (if applicable)
Wash window/ ledges/ tracking
Bedding change (must be stripped prior)
Wash baseboards
Clean sliding door and tracking
Clean ceiling fan (within reach)
Living Room / Family Room
Living Room/ Family Room Basic
Wipe tables/ desks
Dust blinds
Dust and wipe all surfaces
Vacuum
Wash floor
Clean mirrors
Disinfection of all high touch points
Deep Clean
Dust pictures
Spot clean blinds/ wash if applicable
Wash walls
wash windows/ ledges/ tracking
Vacuum furniture
Wash baseboards
Home Office
Home Office Basic
Clean upclutter
Dust
Dust blinds
Clean mirrors/dust pictures
Vacuum
Wash floor
Disinfection of all high touch points
Deep Clean
Spot and clean dust blinds
Wash windows and tracking
Wash walls
Wash baseboards
Clean doors
Laundry/ Utility Room
Laundry/ Utility Room Basic
Clean sink/ countertops
Wipe washer/dryer
Sweep and wash floor
Disinfection of all high touch points
Deep Clean
Wash windows/tracking
Clean baseboards
Dust and spot clean blinds
Laundry (upon request)
Inside Entry/Foyer
Inside Entry/ Foyer Basic
Dust/vacuum/ wash floors
Dust blinds
Disinfection of all high touch points
Deep Cleaning
Wash windows/tracking
Wash door
Spot clean blinds (if applicable)
Wash baseboards
Wash walls
Submit
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