Cleaning Service Request Form

Name*

First NameLast Name

Email*

example@example.com

Phone Number*

Please enter a valid phone number.

How did you hear about us?*

Clark & Blake Realty GroupPast ClientReferral

Property Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Requested Service Date *

Date

Requested Service Time *

Hour Minutes

AM/PM Option

Type of Residence*

Type(s) of Flooring*

#of Bedrooms*

#of Bathrooms*

Services Requested*

Basic Maintenance CleaningDeep Cleaning

Additional Services Requested

Appliances (Interior of Stove, Interior of Fridge)LaundryDishwashingWindows (window sills are included in basic services, window pane washing is not)Grout ServicesDeCluttering and OrganizingPest Bombing & CleanupCarpet Shampooing (vacuuming is included in basic services)

**Disclosure Statement**

We are pleased to offer comprehensive cleaning services tailored to meet your needs. Our team is insured and equipped to handle a variety of cleaning tasks, ensuring your space is maintained to the highest standards of cleanliness and safety. We prioritize your satisfaction and adhere to strict protocols to deliver efficient, reliable, and effective cleaning solutions.

The Client agrees to indemnify and hold harmless the service provider from any claims, damages, or liabilities arising from the cleaning services provided. In the event of a dispute, both parties agree to mediate in good faith before pursuing any legal action.

If you have any questions about our services or products used, please feel free to reach out. Thank you for choosing us for your cleaning needs!