Residential Cleaning

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Your Name*:
Telephone Number*:
Email*:
Carpet	Bedroom(s) #
	Dining Room
	Family Room
	Living Room
	Hallway(s)#
	Stairs #
	Other - Rooms
Area Rug(s)	Sizex Natural FibreSynthetic Fibre
	Sizex Natural FibreSynthetic Fibre
	Sizex Natural FibreSynthetic Fibre
	Sizex Natural FibreSynthetic Fibre
	Sizex Natural FibreSynthetic Fibre
	Sizex Natural FibreSynthetic Fibre
Upholstery	Sofa #
	Loveseats #
	Chairs #
	Ottoman #
	Dining Room Chair(s) #
	Mattress Twin #
	Mattress Double #
	Mattress Queen #
	Mattress King #
	Other Items
Drapery	Sheers # of Pleats
	Unlined Panels # of Pleats #
	Lined Panels # of Pleats
	Valance(s) total linear feet #
	Flat panels total square feet #
Blinds	Type Vertical Silouette Duette Roller Shade Pleated Shade Sunscreen Luminette Width feet - # of units
	Type Vertical Silouette Duette Roller Shade Pleated Shade Sunscreen Luminette Width feet - # of units
	Type Vertical Silouette Duette Roller Shade Pleated Shade Sunscreen Luminette Width feet - # of units
	Type Vertical Silouette Duette Roller Shade Pleated Shade Sunscreen Luminette Width feet - # of units
Other Helpful Information	Do you have pets in your home? Yes No
	Is tobacco used in your home? Yes No
	Does anyone in your home have any allergies or sensitivities? Yes No
	Do you require a stain repellent treatment? Yes No
	Is there any evidence of mold or mildew in your home? Yes No
	Do you require an anti static treatment? Yes No
	Do you require a fire retardant treatment? Yes No
	Are any repairs required to your area rugs or window coverings? Yes No
	If so please elaborate: