Platinum Cleaning Services Request Form
Platinum Cleaning Trusted By Close Neighbors
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
How did you hear about us?
Referral
Web Search
Social Media
Flyer
Property Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Total Square Footage
*
Needed for Deep Cleaning Services - if this doesn't apply place "Zero"
Type of Residence
*
Please Select
Apartment
Commercial
Residential
Duplex/Triplex
Condo
Office
Vacation/Airbnb Rental
Apartment -Move In
Apartment -Move Out
Other
Frequency
*
Please Select
Daily
Weekly
Bi-Weekly
Monthly
Bi-Monthly
Type(s) of Flooring
Tile
Carpet
Hardwood
Vinyl
Marble
Laminate Flooring
Concrete
Porcelain
Parquet
Linoleum
Other
#of Bedrooms
Please Select
1
2
3
4
5
6
7
8
9
10
#of Bathrooms
Please Select
1
2
3
4
5
6
7
8
9
10
Services Requested ($70/hour)
Floors
Windows
Walls
Furniture
Garage
Carpets
Laundry
Meal Preparation
Payment Method
*
Please Select
Cash
Credit Card
Cash App
Venmo
Zelle
We offer various payment options. Please select the option you would most likely use.
Below sections will be filled out by the Company.
Quote
Rows
Price ($)
Hours per week
Total Cost ($)
Floors
Windows
Walls
Furniture
Carpets
Refrigerators
Stoves
Total Amount ($)
Quote Prepared by
First Name
Last Name
Signature
Submit
Submit
Should be Empty: