contact – Mr Clean

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Full Name

Email Address

Phone Number

Service Address

Property Type

If House: May we park our service vehicle in your driveway?

Yes No

If Apartment: Please provide Floor #, Elevator info, and designated parking location.

Select areas and provide estimated square footage

Area Rugs, Living Room Dining Room Bedrooms Hallways Other

Approx. Sq. Footage

Do you have stairs to be cleaned?

Yes No

If yes, how many stairs?

Carpet Condition: 1 to 10

Requested Date

Requested Time

Entry Instructions

Door Code / Specific Entry Notes

Service Agreement

I agree to pre-vacuum all areas and move fragile items before arrival. I understand that payment is due in full upon completion of the service.

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