Full Name

Email Address

Phone Number

Address or Postal Code

Type of Space Type of SpaceApartmentCondoTownhomeHouseSmall Commercial

Approximate Size Approximate SizeUnder 1,000 sq ft1,000-2,000 sq ft2,000-3000 sq ft3,000+ sq ft

Number of Occupants

Pets PetsNoYes - light sheddingYes - heavy shedding

Current Condition Current ConditionWell maintainedModerately maintainedNeeds reset / deeper attention

Priority Areas Priority Areas Kitchen Bathrooms Floors Dusting / surfaces Other

Anything else we should know about your space?

Frequency FrequencyOne-timeBi-weeklyMonthlyAnnuallyNot sure yet

Preferred Day

Preferred Time Preferred TimeMorningMiddayAfternoonFlexible

Access Method Access MethodI will be homeKey providedTo be arranged

Confirmation Confirmation I understand that service recommendations are based on a structured intake