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Contact Information
First Name
Last Name
Address
 
City
State Texas
Zip Code*
   
Contact Phone
Alternate Phone
x
Email Address *
Best time to contact you? ASAP   
Afternoon  		 Morning Evening  
   
Preferred method of contact? Call Me Email Only No Preference
   
How did you hear about us?
(Referral, Search Engine, Other):
 
Service Information
Type of residence *
Number of bedrooms *
Number of bathrooms *
   
Type of cleaning needed * Regular Cleaning  
Move-In/Move-out		 Heavy Cleaning
 Hourly Cleaning
   
Clean inside refrigerator? Yes   No   Not Sure
Clean inside oven? Yes   No   Not Sure
Vacuum Furniture? Yes   No   Not Sure
   - If yes list items (ex. sofa, loveseat, chair)
Do you need CARPET STEAM CLEANING? Yes   No   Not Sure
   
Number of pets living in your home
Approx square feet
How many levels will we be cleaning?
Are you considering recurring service,
if so how often?
   
Are there any specific notes that are relative to the cleaning needed? (ex. pet hair, heavy build-up areas, unique surfaces)

 
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