Home Care & Cleaning Client Questionnaire
Please make sure to read each question, and answer honestly for the most accurate quote. Please understand quotes are considered ESTIMATES and prices MAY vary depending on overall condition of home upon our arrival. Honesty is the best policy!

Upon completion of the form, you will be contacted to set up an appointment so that we may meet you and tour your home in order to best evaluate it and the services your family needs before a final quote can be given.

Email address *
Date of Form Completion *
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First and Last Name *
Your answer
Full address INCLUDING City/State (Please make sure you provide the address of the home you need the cleaning for, if different from your home address.): *
Your answer
Phone number: *
Your answer
How would you prefer to be contacted? *
Email Address: (this is where much information and your final quote will be sent, please keep an eye out, be sure to check spam folder!) *
Your answer
What type of cleaning are you interested in? *
Required
If you're looking for regular services, are you interested in.... *
What is the approximate square footage of the home? *
Your answer
How many bedrooms are there? *
Your answer
How many bathrooms are there? *
Your answer
What is the level of mold/soap scum/build up in your shower(s)? *
Do you have the following that we will be cleaning? *
Required
What type of counter tops do you have? *
Your answer
Do you have stainless steel in your home? *
What is the level of dust in your home? (please note that most of us in our area do have a high level of dust in our homes, so please answer as honestly as you can) *
What type of home do you live in? *
How many stories is the home? *
Your answer
What types of flooring do you have in the home? *
Required
Do you have pets? *
If you have pets (cats and dogs), how many OF EACH do you have? *
Your answer
If pets, do they shed? *
Your answer
Do children live in the home? *
If you have children, how many? *
Your answer
Does any cigarette smoking occur inside the home? *
Your answer
Have you ever used a Professional Cleaning Service? *
IF you have used a professional cleaning service, how long ago? *
Your answer
What is most important to you when cleaning your home?
Your answer
What method of payment do you prefer to use?
Have you or a professional company deep cleaned your home in the last 3 months? (This includes all rooms of the house, top-to-bottom- including dusting, door frames and baseboards, blinds, windows, etc? *
On a scale of 1-10, with 1 being extremely neglected and overwhelming, 5 being just a little dusty, but no major scrubbing or picking up needed, and 10 being VERY clean already, how would you rate the overall condition of your home? *Please note that if you answer dishonestly, we can not accurately quote you, and getting a lower quote is not a guarantee that we will do the entire job for that amount. *
How did you hear about us?
Your answer
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