Housekeeping Service Request Form

Name

First NameLast Name

Email

example@example.com

Phone Number

Please enter a valid phone number.

Type of Service Requested

General CleaningDeep CleaningMove-In/Move-Out CleaningOther

Please specify

Frequency

One-TimeWeeklyBi-WeeklyMonthly

Preferred Date and Time

Date

Hour MinutesAM/PM Option

Number of Rooms to be Cleaned

Additional Services Requested:

Type of Property

HouseApartmentCondoOther

Number of Bedrooms

Square Footage

Provide any specific instructions or requests here, such as areas of focus, cleaning product preferences, or any other special requirements.

Terms and Conditions:

By submitting this request, I acknowledge and agree to the following:

The service requested will be scheduled based on availability.
Pricing may vary depending on the size of the property and specific cleaning requirements.
Payment is due upon completion of the service.
Changes or cancellations to the service appointment must be made at least 24 hours in advance.
The service provider will not be liable for any damages or losses resulting from the cleaning service.

Signature

Date

Service Details: