Cleaning Client Information Form

Cleaning Client Information Form

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Customer Information
Name

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Home Phone
Email*
Preferred Phone
What type of reminder would you like to receive for each service?*

TextEmail
Please check all preferred days for cleanings (including the day we have you scheduled for)
Please check your preferred times of the day for cleanings
About the home

Client's Home Information
(Apartment, House, Condo, Studio etc.)
# of bedrooms*
# of bathrooms*
Approx. square foot (Optional)
# of stories*
More than 50% carpeted
Additional Services

Carpet CleaningWindow CleaningUpholstery CleaningLaundry ServiceDishwashingOrganizingOther
Cleaning Supplies:

Client will provide cleaning supplies.Cleaning company to provide cleaning supplies (may have an additional cost).
Special Instructions or Notes:
List tasks to exclude:
Should be Empty: