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Name
*
First
Last
Email
*
Phone
Address
*
Street Address
City
ZIP Code
Have You Used a Cleaning Service Before?
*
No
Yes
Frequency of Cleaning
*
Weekly Cleanings
Cleaning Every 2 Weeks
Monthly Cleanings
Deep Clean/One-Time
Post Construction
Office Cleaning
How Soon Are You Looking For a Cleaning or Estimate?
*
Looking for a miracle, need it done asap or yesterday!
No huge rush, sooner than later, but willing to wait.
Comparing price/services, would like to make a decision.
Square Footage
*
700-799 sq ft
800-899 sq ft
900-999 sq ft
1,000-1,099 sq ft
1,100-1,199 sq ft
1,200-1,499 sq ft
1,500-1,999 sq ft
2,000-2,249 sq ft
2,250-2,499 sq ft
2,500-2,999 sq ft
3,000-3,499 sq ft
3,500-3,999 sq ft
4,000-4,499 sq ft
4,500-4,999 sq ft
5,000-5,499 sq ft
5,500-5,999 sq ft
6,000-6,999 sq ft
7,000-7,999 sq ft
8,000-8,999 sq ft
9,000-9,999 sq ft
10,000+ sq ft
Number of Occupants (People)
*
0 occupants
1 occupant
2 occupants
3 occupants
4 occupants
5 occupants
6 occupants
7 occupants
8 occupants
9 occupants
10 occupants
Number of Levels
*
1 level
2 levels
3 levels
4 levels
5 levels
6 levels
7 levels
8 levels
9 levels
10 levels
Number of Bathrooms
*
1/2 bathroom
1 bathroom
1 1/2 bathrooms
2 bathrooms
2 1/2 bathrooms
3 bathrooms
3 1/2 bathrooms
4 bathrooms
4 1/2 bathrooms
5 bathrooms
5 1/2 bathrooms
6 bathrooms
6 1/2 bathrooms
7 bathrooms
7 1/2 bathrooms
8 bathrooms
8 1/2 bathrooms
9 bathrooms
9 1/2 bathrooms
10 bathrooms
Number of Bedrooms
*
0 bedrooms
1 bedroom
2 bedrooms
3 bedrooms
4 bedrooms
5 bedrooms
6 bedrooms
7 bedrooms
8 bedrooms
9 bedrooms
10 bedrooms
Number of Bed Sheets To Be Changed
*
0 bedsheets
1 bedsheet
2 bedsheets
3 bedsheets
4 bedsheets
5 bedsheets
6 bedsheets
7 bedsheets
8 bedsheets
9 bedsheets
10 bedsheets
Number of Shedding Pets
*
0 shedding pets
1 shedding pet
2 shedding pets
3 shedding pets
4 shedding pets
5 shedding pets
Number of Non-Shedding Pets
*
0 non-shedding pets
1 non-shedding pet
2 non-shedding pets
3 non-shedding pets
4 non-shedding pets
5 non-shedding pets
Comments or Questions?
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