Hotel Cleaning Refusal Form
Please complete this form to officially record your decision to decline housekeeping or cleaning service for your hotel room.
Guest Full Name
*
First Name
Last Name
Room Number
*
Date of Refusal
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Type of Cleaning Service Refused
*
Daily Housekeeping
Towel Replacement
Linen Change
Trash Removal
Other
Duration of Refusal
*
Please Select
Today only
Entire Stay
Specific Dates
If "Specific Dates", please specify
Reason for Refusal (optional)
How did you communicate your request?
*
In person
Phone call
Written note
Other
Staff Member Recording Refusal
*
Guest Signature
*
Submit
Submit
Should be Empty: