Cleaning Estimate Intake Form

CLEANING ESTIMATE INTAKE
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:
QUESTIONNAIRE
1. What Services are you interested in?

Other
2. Approximate square footage:
3. Any glass shower doors, if so, how many?
4. Flooring Types

Other
5. Any Pets?
Please check what pets you have?

Other
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?

Other
Client Signature
Note that info collected will be used for marketing purposes but can unsubscribe at any time. www.mamamaids.com
Should be Empty:

CLEANING ESTIMATE INTAKE