Cleaning Estimate Intake Form

CLEANING ESTIMATE INTAKE
Name
First NameLast Name
Cell Phone
Please enter a valid phone number.
Email Address
example@example.com
Address
Street Address
Street Address Line 2
CityState / Province
Postal / Zip Code
Total Bedrooms
Total Bathrooms
Number of bedrooms and bathrooms needing cleaned:
QUESTIONNAIRE
1. What Services are you interested in?
One-timeWeeklyBiweeklyTriweeklyMonthlyMove In/Out
2. Approximate square footage:
3. Any glass shower doors, if so, how many?
4. Any tile?
5. Any pets? (If so, type and number of pets)
6. Ever had a cleaner before?
7. Any problem areas or special projects?
8. How would you describe dirt level?

1
2
3
4
5
6
7
8
9
10
1 is not much dirty, 10 is extremely dirty
9. Are there any indoor smokers in the home?
10. How did you hear about us?
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CLEANING SERVICES TERMS OF SERVICE
Client Signature
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CLEANING ESTIMATE INTAKE