Pre-Estimate Client Intake
Please fill out this form as thoroughly as possible and we will get back to you as soon as we can, thank you!
Name
First Name
Last Name
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
How many bedrooms?
How many bathrooms?
What is the square footage?
How soon would you like to schedule services?
ASAP
Within 2 weeks
I'm flexible
What type of cleaning are you looking for?
Move in/Move out
Deep Clean
Maintenance Clean
Custom
How often will you be in need of services?
One time
Weekly
Bi-weekly
Monthly
Other
What date would you prefer to schedule an estimate?
-
Month
-
Day
Year
Date
What time of day works best for an estimate?
Hour Minutes
AM
PM
AM/PM Option
Any other day/time you would like to include?
Do you have any special cleaning requests or instructions?
Any allergies or sensitivities that the cleaning staff should be aware of?
Do you have any pets? If so, please specify:
Is there a preferred day/time for cleaning? If so, please specify:
Are there any parking or access restrictions for the cleaning staff? If so, please specify:
Are you able to communicate via text message? If not, please specify:
What form of home access will be provided? Please list at least one form of entry to be used:
How did you hear about Newly Maid Cleaning?
Would you like to request that we use only non-toxic products for your home (price may be effected)?
Yes
No
Have you had any professional cleaning in your home previously?
Yes
No
If yes, please briefly expound on your experience and why you are seeking a new service (please include how recent your last professional cleaning was completed):
Are you a former or active military member?
Yes
No
Before your first cleaning can begin, a 50% deposit and a signed service agreement is required. Will either of these steps present any difficulty for you?
No, that's fine
Yes
If yes, please explain:
What is your preferred form of payment?
Cash
Check
Credit/Debit card
Any other important information, special requests, or cleaning add-ons you would like us to know about?
Submit
Should be Empty: