Laundry Cleaning Request Form

Laundry Cleaning Request Form

Please complete this form so we can schedule you accordingly.
Full Name *
Email Address*
example@example.com
Phone Number*
Please enter a valid phone number.
Pickup and Delivery Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Type a question

I am a returning Fresh4U ProCare customer wanting to REBOOK the same service with NO CHANGES to pick-up or delivery address. **If requesting FIRST AVAILABLE, you may skip to SUBMIT.**
Which laundry service works best for you? *please note, all pricing below is before promo codes/discounts.*

Wash, Dry & Fold (standard return time- 48hrs.)Wash, Dry, Fold (customer Supplies)Express (24-hour delivery)Same-Day Priority $2.85/lb.
Details of Laundry Items (e.g., types of clothes, special instructions)
Desired Laundry PICK-UP option:

First availableI have a specific day/time that works best for me
IF you have a specific PICK-UP day/time request, enter it below. *EXAMPLE: I prefer a Monday morning pick-up.*
Enter special laundry instructions here: *EXAMPLE: please roll towels OR I'd like my laundry delivered to a different address.*
Do you have a Fresh4U promo. discount code, or who referred you?
How did you hear about us? *Google, referral, Facebook, etc*
Select Your Wash Preference*

No Preference, just want them fresh!TideZum-AmberElements- UnscentedElements- Citrus ScentSeventh Generation Free & ClearArm & Hammer Plus Oxi-CleanAll Free & Clear
Select You Color-Safe Bleach Preference*

NoneOxi-CleanSeventh Generation Non-Chlorine Bleach
Select You Color-Safe Fabric Softener (Dryer) Preference*

NoneBounce Free & GentleSeventh Generation- Free & ClearSeventh Generation- LavenderDowny (Original)Arm & Hammer - Clean ScentsationArm & Hammer- Order BlastGain
Signature to Confirm Request*

Clear
Should be Empty: