Client Intake Form

Client Intake Form

Please fill out this form to help me understand your cleaning needs and preferences. I look forward to providing you with excellent service.
Full Name*

First NameLast Name
Email Address*
example@example.com
Phone Number*
Please enter a valid phone number.
Service Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Approximate Square Footage of Residence
Number Of Bedrooms, Bathrooms, Living rooms, Offices, Dens, Etc?
Have You Had A House Cleaner Before?

YesNo
Preferred Cleaning Frequency*
What Type Of Cleaning
Preferred Time Slot for Service*

Hour Minutes

AM/PM Option
Notes About Your Cleaning Needs or Concerns
Should be Empty: