Client Information Form

Client Information Form
Customer Information
Name

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Home Phone
Format: (000) 000-0000.
Email*
Preferred Phone
TextEmail
Please check all preferred days for cleanings
Please check your preferred times of the day for cleanings
Standard Clean (Recurring Clean, After 1st initial Deep Clean)One Time Deep CleanMove In Or Out CleanAfter Party Clean UpPost-Construction Clean Up
Weekly CleanBi-WeeklyMonthlyEvery 2 MonthsDailyOther
One TimeEvery 2 MonthsEvery 6 MonthsOther
WeeklyBi-WeeklyMonthlyDailyJust Once
ABOUT THE HOME

Tell Me About Your Home :)
# of bedrooms*
# of bathrooms*
Approx. square foot
It’s ok if you don’t know, let us know if you live in a Apartment, Townhouse, Small House Or Large House
# of stories*
More than 50% carpeted
Carpet Cleaning(Shampooed)Window CleaningBaseboard CleaningLaundry ServiceOrganizingWall CleaningInside Cabinet Deep CleaningRefrigerator-Oven Deep CleaningOther
Client will provide cleaning supplies.Cleaning company to provide cleaning supplies (may have an additional cost).
YesNo
Special Instructions or Notes:
List tasks to exclude:
Signature

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ABOUT THE HOME