Cruz Cleaning Service LLC
Estimate Intake
Name
*
First Name
Last Name
Cell Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
QUESTIONNAIRE
1. What Services are you interested in?
*
One-time
Weekly
Biweekly
Monthly
Residential Cleaning
Commercial/Office Cleaning
Move-In/Move-Out Cleaning
Special Event Cleaning
Other
Special Service Add Ons
Laundry Service
Carpet Cleaning Service
Dish Washing Service
Deep Oven Cleaning
Deep Fridge Cleaning
Number of bedrooms and bathrooms needing cleaned:
*
2. Approximate square footage:
*
5. Any pets? (If so, type and number of pets)
*
6. Ever had a cleaner before?
7. Any problem areas or special projects?
8. How would you describe dirt level?
*
not much dirty
1
2
3
4
5
6
7
8
9
extremely dirty
10
1 is not much dirty, 10 is extremely dirty
9. Are there any indoor smokers in the home?
*
Please Select A Date And Time For Services
*
10. How did you hear about us?
Facebook
Google
Reference
Other
Submit
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