Are you a returning customer? (Choose One) *

Yes

No

Do you have stairs to clean? How many steps? *

None

3

6

14

Do you own a cat(s)? (Choose One) *

Yes

No

Do you own a dog(s)? *

Yes

No

How many rooms do you need cleaned? *

0

1

2

3

4

5

6

Tell us if there is anything else you need cleaned. Is it carpet, hardwood or tile? Let me know if you include stairs, hallways or area rugs. If sofa/sectional, tell me how many sections. *

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Which Time Slot Would You Prefer? *

Morning (8 am - 11 am)

Afternoon (1pm - 3 pm)

Late Afternoon (4pm - 6pm)

Anytime is fine (flexible)

Which Day Of the Week would you be available for your appointment (within the next 7 days). *

Mon

Tue

Wed

Thu

Fri

Any Day (Earliest Available)

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Street Address (include Apt Number if any) *

City *

State *

Postal code *

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First Name *

Last Name *

Email *

Phone *

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