Cleaning Services Client Intake Form

Please take a few moments to complete the form accurately and thoroughly. Rest assured that all information provided will be kept confidential and used solely for the purpose of delivering exceptional cleaning services to you.

Client Information

Full Name:
Email Address:
Phone Number:
Address:
City:
State:
Zip Code:
Preferred Method of Contact:	[ ] Email [ ] Phone

Cleaning Preferences

Type of Cleaning Service Needed:
Frequency of Service:
Preferred Day(s) of Service:
Preferred Time of Service:

Property Information

Type of Property:
Number of Bedrooms:
Number of Bathrooms:
Square Footage:
Pets (if any):
Special Instructions:

Additional Information

How did you hear about us?
Any specific concerns or areas of focus?
Any allergies or sensitivities we should be aware of?

Agreement and Signature

I agree to the terms and conditions outlined by [Your Company Name]. By signing below, I confirm that all information provided in this form is accurate and complete to the best of my knowledge.

Signature:

Date:                              

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