New Customer Service Request Form

Name *

First NameLast Name

Name of party responsible for payment (if different from above).

First NameLast Name

E-mail

example@example.com

Phone Number

Area CodePhone Number

Select which methods we may contact you. (Select all that apply)*

CallTexte-mail

Address if different from last time.

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Number of rooms to be serviced*

Surface Type/s*

Service Requested*

CleaningOdor/Sanitize/Pet AccidentMove-out cleaningOther (Please specify below.)

Will we be moving furniture? Please Note: We do not move large items such as dressers that are full/in-use, china cabinets, entertainment centers, grandfather clocks or beds sizes full and up.*

YesNoArea is empty.

Preferred service date. Please Note: All selections are subject to current availability. Staff will contact you to confirm schedule.

Additional Instructions: Please indicate-How we will gain access and any other important details here.*

Deposit Policy:

A non-refundable deposit of $106 will be charged to the card provided at the time of scheduling. The deposit is forefit if the customer fails to provide access to the service location at the scheduled time, fails to cancel their appointment with more than 24 hours notice, or the utilities, or sewer/septic are found not in service.

Utlity Policy:

Utilities and sewer/septic must be available at the time of service, no exceptions. If utilities or sewer/septic are found out of service without prior notice, they must be restored to reschedule.

Pet Policy:

Pets must be contained for their safety and staff safety, no exceptions.

Furniture Policy:

Furniture is not automatically included unless specified. If customer elects to move furniture themselves, everything must be moved before the technician arrival time. The customer cannot move furniture during the cleaning for safety reasons. The customer acknowledges and accepts the furniture items listed in the section above as items that we do not move in any circumstance.

I agree to the policy statements above.

Billing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Returning Residential Service Request