CUSTOMER INFORMATION
01 Full name *
*
First Name
Last Name
02 Phone number *
*
Format: (000) 000-0000.
03 Email address *
*
example@example.com
04 Service address *
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
PET + PROPERTY INFORMATION
05 What type of pet(s) are we cleaning up after? *
*
Dog(s)
Cat(s)
Both
Other
06 How many pets do you have? *
*
1
2
3
4
5+
07 Approximate yard size *
*
Under 1/4 acre
Over 1/4 acre
Not sure
SERVICE REQUESTED
08 How often would you like Scoopem to visit? *
*
2x weekly
Weekly
Every 2 weeks
Monthly
One-time cleanup
Back
Next
SERVICE REQUESTED / CONTINUED
09 When was the yard last cleaned of pet waste? *
*
Within the last week
1-2 weeks ago
2-4 weeks ago
More than 1 month ago
Not sure
10 How would you describe the current yard condition?
Light cleanup
Average buildup
Heavy buildup
Very heavy / has not been cleaned in a while
Final pricing may vary with yard size, time since last cleanup, and the amount of waste.
PROPERTY ACCESS + SAFETY
11 How will we access the cleanup area? *
*
Open / unlocked gate
Locked gate
Side entrance
Front yard
Other
12 Will any dogs be outside during service? *
*
No
Yes - friendly with strangers
Yes - I will secure my dog
13 Where is your outdoor trash bin located?
14 Anything we should know before entering your property?Gate codes, parking, pets, hazards or other instructions
ACKNOWLEDGMENT
I will make sure the cleanup area is accessible on my service day.
I understand this form does not confirm a service date until booking is confirmed.
Submit
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