Home Cleaning Service Agreement
We hope that you enjoy our service and we encourage you to provide us with any feedback.
Name
First Name
Last Name
Appointment Date
-
Month
-
Day
Year
Date
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Home Phone
Format: (000) 000-0000.
Cell Phone
Format: (000) 000-0000.
Work Phone
Format: (000) 000-0000.
E-mail
example@example.com
Square footage of home
# of bedrooms in home
Please Select
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
# of bathrooms in home
Please Select
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
In the event we have to reach while you cleaning appointment is taking place what is your preferred means of contact?
Please Select
Cell Phone
Work Phone
Home Phone
Email
What type of service applies to you?
First Time Appointment
One Time Appointment
Weekly Service
Bi-weekly Service
Monthly Service
Power Cleaning
Other
How do we gain entrance?
Keys with office
Keys with doorman
Someone will grant access
Other
SPECIAL INSTRUCTIONS
Signature
In the event that we have to temporarily or permanently change your cleaning consultant, how would you like to be notified?
Please email me
Please call me
Don't email/call, I am OK with any replacements
Submit Form
Submit Form
Should be Empty: