Are you a Returning Client?

Fill out your information

First Name *

Last Name *

Phone Number

E-Mail *

Street Address

City

Zip Code

List a specific item, if any, that previous housekeepers have missed or cleaned poorly

If you could choose one thing that says what a ‘clean house’ is to you, what would it be?

In case everything can’t be finished in the time scheduled, what are your priorities?

Follows my directions

Self-directed

Dependable

Punctual

Fluent in English

Long-term commitment

Friendly

Businesslike

Please select the day you would prefer your housekeeping service MondayTuesdayWednesdayThursdayFriday

Please select the time of day you would prefer your housekeeping service MorningAfternoonDoesn’t Matter

Frequency (Monthly, BiWeekly, One Time) *

Number of Bedrooms

Number of Bathrooms

What is the square footage of your home? 800-16001700-22002300-27002800+

How Did You Hear About Us? Internet SearchSocial MediaReferralReturning Customer

Any Other Comments?

6 + 2 = ? Please prove that you are human by solving the equation *