Request for Estimate or Services

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Thank you for your interest in our services. To request an estimate of cost for our services please fill out the following info
I need info/ to hire* Information only please - I`m just curious or still shopping around Ready to hire - schedule ASAP contingent on acceptance of price
First Name:*
Last Name:*
E-Mail address:*
Home Phone:*
Cell Phone:*
Preferred method of contact*
Type of dwelling* Single family home - 1 story Single family home - 2 or more stories Apartment/Condo Other
Address Line 1: No PO box #s*
Address Line 2:
City:*
State:*
Zip Code:*
# of persons residing in home (total count)*
# of persons under the age of 18*
# of dogs in home*
# of cats in home*
# of birds in home*
Type of services needed* One time move in (No heavy soils/ reclean and sanitize) One time move out cleaning (we need our security deposit back) One time deep/ spring clean One time only lighter cleaning A Deep cleaning following by a regularly recurring maintenance cleans Post Construction cleaning Once a month services - whole home Every other week (bi/wkly) - whole home Every week - whole home Kitchen and bath(s) only special Partial home only (please add notes in the comment section) Rotation of whole & partials (please add notes in comment section) Windows and screen cleaning Organizing Other services I`m not completely sure yet (please add notes in comment section)
desired frequency of services * One time only Once a week Every other week - bi/wkly Once a month - every 4 weeks I`d like to just call in whenever I need additional help I`m not completely sure yet (please add notes in comment section)
preferred days to be cleaned* Monday (am - 9 -12 noon) Monday (pm - 12 noon - 4pm) Tuesday (am - 9 -12 noon) Tuesday (pm - 12 noon - 4pm) Wednesday (am - 9 -12 noon) Wednesday (pm - 12 noon - 4pm) Thursday (am - 9 -12 noon) Thursday (pm - 12 noon - 4pm) Friday (am - 9 -12 noon) Friday (pm - 12 noon - 4pm) Saturday (We do not guarantee to be available every Saturday) Sunday (We do not guarantee to be available every Sunday) I`m not completely sure yet
Requested start date*
Closest approximate sq footage size of home (please round up as needed)* 500 sq ft or less 501 - 750 sq ft 761 - 1000 sq ft 1001 - 1250 sq ft 1251 - 1500 st ft 1501 - 1750 sq ft 1751 - 2000 sq ft 2001 - 2250 sq ft 2251 - 2500 sq ft 2500 - 2750 sq ft 2851 - 3000 sq ft 3001 - 3250 sq ft 3251 - 3500 sq ft 3501 = 3750 sq ft larger than 3751 sq ft - please add info in comments
Parking situation or possible obstructions* Parking avail in front or back of home (very close access) Guest parking only avail (short haul from home) Parking is very limited (long haul may be required) 2nd or higher story apt/ condo with no elevator Gated community that requires gate access codes Vendor parking passes required for parking Access only granted by onsite property management office
# of bedrooms and baths* Studio Apt 1 bedroom/ 1 bath 1 bedroom / 1.5 baths 2 bedroom / 1 bath 2 bedroom / 2 baths 2 bedroom / 2.5 baths 3 bedroom / 1 bath 3 bedroom / 1.5 baths 3 bedroom / 2 baths 3 bedroom / 2.5 baths 4 bedroom / 2 baths 4 bedroom / 2.5 baths 4 bedroom / 3 baths 5 bedroom / 3 baths 5 bedroom / 3.5 baths Other - please note in comments section
Extra services required Windows washing Mini Blind washing Oven cleaning Refrigerator cleaning Wall washing (not referring to shower walls) Tile floor grout cleaning Steam cleaning floors Power scrubbing floors Carpet cleaning Other - please note in comments section
Clutter levels* Empty home / no furnishings Little to no clutter Average clutter Slightly more than normal clutter Very cluttered
Soil levels* Little to no soil/ build up A slight amount of soil/ build up Average soil/ build up Slightly more than normal soil/ build up Very soiled / lots of build up
Last time home was thoroughly cleaned* We clean regularly but we have better things to do - within 30 days We clean occasionally -within the last 60 days We clean only when we absolutely need to - its been 2 to 6 months Please don`t judge me please if I say never - its been over 6 months
We try to answer all requests for information received during our normal working hours within a 4 hours of receipt. Requests received after hours or on days that we are closed may not be answered until our next business day. Upon receipt of your request a representative from Home Care Referral Agency will contact you and provide to you the information / quote that you are requesting. Please be advised that all quotes are based upon assumptions that homes are in average condition per your descriptions . Extreme soil, build up and clutter will assuredly increase pricing. If we find upon entering the home that the conditions do not match what we based our quote on we will contact you first before starting work to discuss any pricing changes or prioritizing your needs so that we can fit your budget Scheduling is based upon availability. We try our best to fill your requests but popular days and times fill up quickly and may not be available.
Questions or comments
Questions/Comments
How did you hear about us?* Newspaper ad Phone book Friend Search Engine Direct Mail Door hanger Angie`s List Yelp Nextdoor Other
Can we hold on to your info* Yes, I would like to be contacted again if you run any Sales No, I`d prefer that you not contact me beyond this one request
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