Housekeeping Service Request Form for Nook & Cranny Cleaning LLC
(Please fill out all areas for an accurate estimate.)
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Preferred form of contact:
*
Please Select
Text
Call
Email
Service Details:
Type of Service Requested
*
Maintenance Cleaning
Deep Cleaning
Move-In/Move-Out Cleaning
Office
Post-Construction
Short-term Rental
Other
Please specify
Frequency
*
One-Time
Weekly
Bi-Weekly
Monthly
Preferred Date and Time
*
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Property Details:
Additional Services Requested:
Inside Oven Cleaning
Inside Refrigerator Cleaning
Interior Window Cleaning
Vinyl Blinds
Baseboards
Other
Type of Property
*
House
Apartment
Condo
Office
Other (Please Specify)
Are there pets present in the home?
*
Please Select
Yes
No
Number of Bathrooms
*
Number of Bedrooms
*
Square Footage (per tax card information)
*
Have you ever had a professional cleaner service your property?
*
Please Select
Yes
No
Are there any active infestations (roaches, bed bugs, rats, mice, etc)?
*
Please Select
Yes (if yes, please explain)
No
If the answer is yes to the question above, please explain:
Signature
*
Date
*
-
Month
-
Day
Year
Date
Submit
Submit
Should be Empty: