Cleaning Estimate Intake Form

Name

First NameLast Name

Cell Phone

Please enter a valid phone number.Format: (000) 000-0000.

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:

1. What Services are you interested in?

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?

9. Are there any indoor smokers in the home?

10. How did you hear about us?

CLEANING ESTIMATE INTAKE