Service Inquiry Questionnaire

Today's Date

SERVICE INFORMATION

Date of Service Request

Primary Services Requested (Select All that apply)
—Please choose an option—Deep CleaningMaintenance CleaningUpholsteryFlooringMove In/OutShowcaseVehicleHoarding

Is this a Residential or Commercial request?
ResidentialCommercial

Desired Cleaning Frequency
Per CleaningDailyWeeklyMonthlyQuarterlyBi-YearlyYearlyOther

Service Contract End Date

CONTACT INFORMATION

Business Name (if Applicable)

First Name

Last Name

Email Address

Telephone #

Website / Blog URL

SERVICE ADDRESS DETAILS

Service Street Address

City

State
Illinois - ILAlabama - ALAlaska - AKArizona - AZArkansas - ARCalifornia - CAColorado - COConnecticut - CTDelaware - DEFlorida - FLGeorgia - GAHawaii - HIIdaho - IDIllinois - ILIndiana - INIowa - IAKansas - KSKentucky - KYLouisiana - LAMaine - MEMaryland - MDMassachusetts - MAMichigan - MIMinnesota - MNMississippi - MSMissouri - MOMontana - MTNebraska - NENevada - NVNew Hampshire - NHNew Jersey - NJNew Mexico - NMNew York - NYNorth Carolina - NCNorth Dakota - NDOhio - OHOklahoma - OKOregon - ORPennsylvania - PARhode Island - RISouth Carolina - SCSouth Dakota - SDTennessee - TNTexas - TXUtah - UTVermont - VTVirginia - VAWashington - WAWest Virginia - WVWisconsin - WIWyoming - WY

Zip Code

Cleaning Area Sq. Footage

# of Bedrooms

# of Kitchens

# of Bathrooms

# of Living Rooms / Shared Areas

ADD-ON SERVICES

Bathroom Add-Ons (Select All that apply)
ALL BATHROOM ADD-ONSScrub tile floor &/or groutWindow Washing (Interior)Outside window & trackWindow blinds & window framesClean inside medicine cabinet & all other cabinetsHandwash walls (latex paint only)Clean inside linen closet & shelvesThorough cleaning of woodwork & wall trimClean & organize makeup vanity in addition to countersHandwash blind louvers

Kitchen Add-Ons (Select All that apply)
ALL KITCHEN ADD-ONSWash excessive amount of dishesClean top of cabinet (not to the ceiling)Clean inside cabinets &/or drawersClean inside oven, refrigerator, &/or freezerClean under greasy range hood & filterDeep Clean window blinds & window framesHand wash walls (latex paint only)Clean Interior WindowsOutside window & trackScrub tile floor &/or groutHandwash blind louvers

Living Areas Add-Ons (Select All that apply)
ALL LIVING AREAS ADD-ONSGlass window interior &/or exteriorClean inside drawers or furnitureDeep Clean window blinds & window framesWipe both sides of door with damp microfiberClean inside cabinetsDust hanging lights, ceiling fans & blades

Bedroom Add-Ons (Select All that apply)
ALL BEDROOM ADD-ONSInterior windows cleanedRemove books from bookshelves / clean shelvesDeep Clean window blinds & window framesWipe both sides off door with damp microfiberClean inside all cabinets & drawersDust hanging lights, ceiling fans, & blades

PAYMENT METHOD

How would you like to Pay for your Services?
ZellePayPal (QR Code)PayPal (Invoice)PayPal (paypal.me)Stripe (Invoice)Quickbooks (Invoice)Cash (in-person)Credit Card (in-person)Chase Quick Pay

PAYMENT FREQUENCY

How often would you like to Pay for your Services?
Per CleaningDailyWeeklyMonthlyQuarterlyBi-YearlyYearly

SERVICE NOTES

Service Notes (optional)

CLIENT SIGNATURE

Print Signature

FILE UPLOADING

Please Upload any files, property images, etc. to help use to properly prepare for your appointment!

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