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
E-mail
*
example@example.com
Phone Number
*
type without type (0) ex.9222223480
Phone Number
*
type without type (0) ex.9222223480
Square footage of house
*
# 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
How do we gain entrance?
*
Keys with office
Keys with doorman
Someone will grant access
SPECIAL INSTRUCTIONS
Please type your full name. This will serve as your electronic 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
Signature
*
scores us ( for first time no need to score)
Worst
1
2
3
4
Best
5
1 is Worst, 5 is Best
Submit
Should be Empty: