Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
-
Area Code
Mobile Number
Property Address
*
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Housecleaning Information
Total Number of bedrooms
*
Please Select
1
2
3
4
5
6
7
8
9
10
10+
Please include all bedrooms even if you don't want them cleaned
Total Number of bathrooms
*
Please Select
1
2
3
4
5
6
7
8
9
10
10+
Total Number of toilets
*
Please Select
1
2
3
4
5
6
7
8
9
10
10+
Home Stories
*
Single
Double
3 Stories
Preferred cleaning schedule
*
Weekly
Every 2 weeks
Every 4 weeks
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Please select which best describes who will be funding the cleans
*
Self Funded
NDIS
DVA
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What are your preferred days for your clean? (Choose all that apply. The more flexible you are, the more likely we can help you.)
*
I am flexible
Monday
Tuesday
Wednesday
Thursday
Friday
Will someone be home, or will you leave us a lockbox code?
*
Someone will be home to let the cleaners in.
I will leave a lock box code on the date closer to the clean
Your Feedback
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This helps us track where our customers are coming from
Do you have any notes you'd like to add?
For example, rooms you need to exclude, or anything else
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