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First
Last
Phone
Contact time
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Any
Mornings
Afternoons
Evenings
Your Email
Street address
City
Zip code
Service requested
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General cleaning
Deep cleaning
Move in cleaning
Move out cleaning
Office cleaning
Steam carpet cleaning
Tile cleaning
Upholstery cleaning
Weekly cleaning
One-Time Deep Clean
Other
Square Feet
Number of occupants
Your Name
Pets?
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Dogs
Cats
both
none
How old is your home?
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Under 5 years
5- 10 years
10- 20 years
over 20 years
Tell us the total number of each:
Toilets
Showers
Bedrooms
Check all types of flooring that apply to your home:
Hardwood
Vinyl
Carpet
Ceramic
Stone tile
Laminate
Amount of clutter (knickknacks, furniture,plants,pictures etc.)
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None-empty house
Very little
Average
More then average
Very cluttered
On a scale of 1-10 (10 being the dirtiest) what level of cleaning is required?
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1
2
3
4
5
6
7
8
9
10
List your requested start dates in the order of preference. Move-out/in cleaning, One-time cleaning and initial cleaning can be done on weekends.
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