New Housecleaning Form





How did you hear about us?:

How did you hear about us? (Other):

Primary Phone:

Primary Phone Number:

Secondary Phone:

Secondary Phone Number:

Apt #:

Cross Street:

Special instructions for entering:

Date of cleaning (Enter MM/DD/YYYY):

Time of Cleaning:

Number of workers:

*Please note that our rates are per worker.

Job Description:

Number of bedrooms to clean:

Number of bathrooms to clean:

Do you have pets?:

Worker expected to bring supplies:





Type of service needed:

How often would you like to hire the worker for regular cleaning?:

Explain special needs:

*We will let the worker know what you would like them to do, but we also recommend that when the worker arrives you walk them around your place so that they know exactly what you would like them to do. They will also bring a cleaning checklist, which is a great tool that lists the different cleaning tasks they offer.