First Name: *

Last Name: *

Email: *

Phone: *

Zip Code: *

Are you currently using a cleaning service? *

Yes

No

What service are you interested in? *

Weekly

Bi-Weekly

Monthly

Move In / Move Out

Spring Cleaning / Deep

Office Cleaning

Specify the date:

What type of property?

House

Office

What is the square footage of the space that needs cleaning?

under 1500 sq ft

1501-2500 sq ft

2500-3500 sq ft

How many people live in the home?

How many kids live in the home?

Do you have pets?

No pets

Cat

Dog

More than 2 pets

How many stories?

One

Two

Three

Four

How many bedrooms?

How many full bathrooms?

How many half bathrooms?*

Number of additional rooms?

How many home furnishings & decorations?

Minimal

Average

High

What type of flooring do you have?

More carpet than hard floor

Mostly hard floor

Other

How many sets of stairs?

0

1

2

3

4

Other

Add cleaning extras?

Inside fridge

Inside oven

Inside cabinets

Interior windows

State of home:

Good

Fair

Construction

Tidiness/Neatness:

Uncluttered

Tidy

Moderately cluttered

Cluttered

How did you hear about us?

Flyer

Facebook

Instagram

Google

Referral

Next Door

Other

Referral Name:

Do you have a coupon code?

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