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 Picker Icon

Address *

Home Phone *

Area Code Phone Number
Cell Phone *

Area Code Phone Number
Work Phone

Area Code Phone Number
E-mail *
Square footage of home *
# of bedrooms in home
# of bathrooms in home
In the event we have to reach while you cleaning appointment is taking place what is your preferred means of contact? *
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
Should be Empty:

Home Cleaning Service Agreement