Are there any stains evident? Please State..
Rooms to be cleaned
Number of room type
Total Size in Metres ²
Fibre Type
Which floor?
Room
Empty?
Scotch Guard Needed?
Living room
1
2
3
4
5
Yes
No
Yes
No
Hallway
1
2
3
4
5
Yes
No
Yes
No
Bedroom
1
2
3
4
5
Yes
No
Yes
No
Stairs
1
2
3
4
5
Yes
No
Yes
No
Landing
1
2
3
4
5
Yes
No
Yes
No
Lounge
1
2
3
4
5
Yes
No
Yes
No
Dining Room
1
2
3
4
5
Yes
No
Yes
No
Kitchen
1
2
3
4
5
Yes
No
Yes
No
Bathroom
1
2
3
4
5
Yes
No
Yes
No
Utility
1
2
3
4
5
Yes
No
Yes
No
Attic
1
2
3
4
5
Yes
No
Yes
No
Other (state)
1
2
3
4
5
Yes
No
Yes
No
Please enter your prefered date for cleaning
Please State AM or PM (4 hour slot only)
Please call AM
Please call PM
Do your require a call to measure? (£10 charge)
Yes
No
Please enter your First name
Please enter your Surname
Please enter your address
Please enter your postcode
Please enter your home telephone number
Please enter a mobile or alternate telephone number
Please tell us your property type
House
Bungalow
Ground Floor Flat
1st Floor Flat
2nd Floor or above Flat
Will we have access to water?
Yes
No
Will we have access to Electricity?
Yes
No
Do you have any additional comments or information you think we may need to know?
Please check the information provided above carefully before submitting this form.