Earthly Essence Cleaning Service Client Form
Thank you for taking the time to answer these questions.
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone
-
Area Code
Phone Number
Email
example@example.com
1. How did you hear about Earthly Essence Cleaning Service?
Kijii
Friend
Other
2. How often do you require a cleaning service?
Biweekly
Weekly
3. How will access to your home be provided? (Please note that providing a cleaning service during a time without people or pets is an optimal environment however if you are more comfortable with being present then I will work around you. I am happy to work around pets if they don't obstruct my cleaning process. I am a proud Dane Mom! (I will always be the only person in your home.)
Key/keypad
Alarm code
Person to give access
4. What type of home do you have?
One Story (bungalow)
Two Story
Bilevel
Townhouse
Walkout
Four Level Split
Apartment
Other
5. What is the square footage of your home?
6. How many bedrooms?
7. How many half bathrooms? (bathrooms with no tub/shower)
8. How many bathrooms with a tub that has a shower curtain?
9. How many bathrooms have a glass shower door that SWINGS?
10. How many bathrooms have a SLIDING glass shower door?
11. How many bathrooms have a tub and completely SEPARATE SHOWER?
12. Do you have a finished basement that you want cleaned as well?
Yes, and I want the basement cleaned as well.
No, I don't have a finished basement.
Yes, I have a finished basement but I do not want it cleaned.
13. If applicable, what areas/rooms do you NOT want cleaned?
14. Will you be paying by cash or e-transfer? Please note that payment is to be left PRIOR to my arrival. If you are paying by e-transfer please email the fee BEFORE I arrive and I will deposit after I have completed the cleaning service.
Cash
E-transfer
15. Would you prefer a hard copy receipt left at your home following a cleaning service or would you like the receipt emailed to you later that day?
Hard copy left at your home
Emailed receipt
16. Do you want me to use any of your cleaning products (if you have special products that you want used for some cleaning tasks) which you would provide? Please keep in mind that environment-friendly cleaning products are great for your home as well as our health. Please check out the "Related Links" page to see what cleaners I use.
Please use all of the great environment-friendly products used by Earthly Essence Cleaning Service.
Yes, please use some of my products to be discussed during the walk-through.
17. Since I will be providing an aromatherapy treatment during the time spent cleaning your home, are there any scents you do not like or would you prefer to opt out?
Please provide the aromatherapy treatment!
Please provide the aromatherapy treatment but do not use certain scents (to be discussed during the walk-through).
I would like to opt out of the aromatherapy treatment.
18. Do you have a preference of weekday for your cleaning service? Please keep in mind that I will try to accommodate you however it depends upon available days.
19. What time range would be suitable for me to come in and provide the cleaning service? Please keep in mind that the longer the time range, the easier it will be to provide the service. Please list the earliest time I can come in (note: the latest that I will begin a cleaning service is 9 a.m.) and the latest time for my departure. (usually this is so that I leave before a client returns home).
20. How many adults live in your home?
21. How many children/teenagers live in your home?
22. Do you have any pets?
Yes
No
23. If you have pets, will they be free in the home or kenneled, etc.
Free inside the home
Kenneled
Not home during cleaning service
N/A
24. If you have pets, what kind(s) and what are their names?
25. If you have pets, how many shed or do not shed?
26. Do you have any special requests or concerns? I want my clients to be happy!
Submit
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