Carpet Cleaning Request Form
What type of building is this for?
*
Private home or residence
Commercial premises
Other
What needs cleaning?
Carpets in whole rooms
Hallways & landings
Rugs
A few specific carpet stains
Stairs and landing
How many rooms need cleaning?
*
1 Room
2 Rooms
3 Rooms
4 Rooms
5 Rooms
6 Rooms
7 Rooms
8 Rooms
9 Rooms
Other
How many staircases require cleaning?
*
None
2 sets
3 sets
Other
What kind of stains need cleaning?
*
None
Polish stains
Coffe or tea Stains
Paint stains
Urine
Pet stains
Blood
Vomits
Oil
Wine
Unknown
Other
Who will move the furniture?
*
I would like the professional to move furniture
I will move the furniture
There is no furniture to move
Other
Extras?
*
Carpet Protection
Deodorazing
Carpet Repair
Other
Name
First Name
Last Name
Email
example@example.com
Phone Number
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