First Name

Last Name

Email

How did you hear about us?
GoogleYelpBest Of Las VegasSocial MediaOtherReferral

When was your home last professionally cleaned?
Less than 1 month3-6 months1+ year(s)This is my first professional service

Are there any areas that need more attention?

Any part of your home that has more build-up or you think will take more time to clean

What is the square footage of your home?

Total Bedrooms
1 Bedroom2 Bedrooms3 Bedrooms4 Bedrooms5 Bedrooms6 Bedrooms

Total Bathrooms
1 Bathroom2 Bathrooms3 Bathrooms4 Bathrooms5 Bathrooms6 Bathrooms

Please rate your home depending on the condition
1-4: Well maintained, no heavy build-up5-6: Average build-up in some areas of the home7-8: Heavy build-up in most areas of the home9-10: Extremely dirty, difficult to see the details of the home
The condition of your home is very important to provide an accurate quote and time estimate for our
cleaners to do a great job!

Were you interested in recurring services after your initial clean?
WeeklyBi-WeeklyMonthlyNot Interested

When would you like your clean scheduled?

Do you have any pets?
Dog(s)Cat(s)OtherNone