Cleaning Client Information Form

Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Home Phone

Format: (000) 000-0000.

Email

What type of reminder would you like to receive for each service?

Preferred time of the day for cleanings?

# of bedrooms

# of bathrooms

Approx. square foot

# of stories

Pets? If yes please fill in how many and kinds

Additional Services

Cleaning Supplies:

How will we access the property for cleanings?

Key, Garage Code, Door Code..etc...

Special Instructions or Notes:

List tasks to exclude:

Signature

Date