Name: *

Home Address: *

Approximate square footage of home: *

Number of Bedrooms *

Number of Full Bathrooms *

Number of Half Bathrooms

Any glass shower doors (if yes how many?) *

Flooring - mainly hard surface vs. carpet *

Any stairs? *

Indoor pets or children? *

Additional information that you feel is important that we know about your home or cleaning needs:

Cleaning frequency? *

Email address: *

Cell Phone # *