CUSTOMER INFORMATION SHEET

CUSTOMER INFORMATON FORM

PLEASE BE SURE TO FILL IN ALL INFORMATION IF YOU DO NOT FILL OUT ALL THE INFORMATION YOUR APPOINTMENT WILL BE VOIDED
Name

First NameLast Name
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Please select an Appointment (All appointments are subject to a 30 Minute arrival window) If there is a grayed out time slot , that means that appointment has been already been reserved.
Please Choose Type of Service Requested

Carpet CleaningTile & Grout CleaningPersian or Oriental RugLaminate FlooringUpholsteryArea RugCommercial Carpet CleaningUnsmoke Thermal FoggerOther
⭐ PLEASE INDICATE WHICH ROOMS WILL BE SERVICED*

LRDRMBRBR1BR2BR3BR4HALLSTAIRSFROGLOFTOTHER
Please Indicate The Reason for Needing Services

Moving OutMoving InGoing On MarketGeneral Cleaning (occupied)Sickness Human or PetOther
Select Your Services Here
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Minimum Charge (ONLY APPLIES TO JOBS WITH LESS THAN $125 OF SERVICES)Minimum charge for all jobs. This also applies for single wide mobile homes.
$125.00



Large Carpet RoomsLarge rooms are described as rooms 12x12 or 144 sq ft or more. Example: Master Bedroom, Living Room.
$80.00 Quantity



Small Carpet RoomsSmall rooms are described as rooms 12x12 or 144 sq ft or less. Example: Kid's Bedrooms, Dining Rooms.
$40.00 Quantity



StairCaseStairs up to 15 steps total. Each additional step is $3.00.
$40.00 Quantity



Free Deodorizer Free deodorizer included in all of our cleanings!
$ Free Quantity



Upholstery Cleaning Standard Size Couch or Sofa
$125.00 Quantity



Upholstery Cleaning Love Seat
$90.00 Quantity



Upholstery Cleaning LG Recliner
$75.00 Quantity



Upholstery Cleaning Standard Size Recliner
$45.00 Quantity



Upholstery Cleaning Ottoman
$25.00 Quantity



Upholstery Cleaning Sofa & Love Seat Combo
$200.00 Quantity



SectionalsPrices Vary on Size! Please Call for accurate pricing
$ Free Quantity



Thermal Deodorizer Unsmoke Treatment this treatment is designed to eliminate odors that are deeply embedded in homes interiors. Quantity chosen is how many levels your home is.
$100.00 Quantity



Subtotal

$0.00

Tax

$0.00

Total

$0.00
PLEASE BE SURE TO DO THE FOLLOWING

Pre-vacumm before our arrival

Remove all breakables from areas to be cleaned

Move any small furniture you wish to move

Leave a space closest to the front door in the driveway

THANK YOU FOR CHOOSING

ABSOLUTE CARPET CARE OF NEW BERN

WE LOOK FORWARD TO SERVING YOU!

WE ACCEPT EVERY FORM OF PAYMENT!

Before you submit make sure you have everything filled out!

Our Minimum Charge is ALWAYS $125.00
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CUSTOMER INFORMATON FORM