Residential Cleaning Services

Please provide information that will assist us in providing you with a custom cleaning estimate. List the areas that bother you the most, special needs, custom cleaning requirements, or any task that requires special attention.

Estimate Request Form

*Required fields in red
*Each checklist must have at least one box checked.*

Contact Info:

Name:

Address:

City:
State: Zip:

Day Phone:

Evening Phone:

PLEASE NOTE: WE REQUIRE YOUR EMAIL ADDRESS IF YOU WOULD LIKE
US TO RESPOND TO YOUR REQUEST.
Thank You!
E-mail Address:

Service Frequency: (Please check one)
Weekly Bi-Weekly 3 Weeks
Monthly Occasional One-Time

Areas Needing Cleaning in Your Home:

Total Square Footage:

Total Bedrooms: Total Bathrooms:

Kitchen: (Please check one or more)
Efficiency Standard
Eat-In With Breakfast Nook

Basement: (Please check one)
Finished Unfinished N/A

Does Your Home Have: (Please check one or more)
Office    Study    Den    Library
Family Room    Living Room    Dining Room
LR/DR Combo    Foyer    Loft
Mud Room
Other(s):

# of Rooms with Wall-to-Wall Carpet With Wood Floor

With Linoleum/Tile With Quarry Tile

# of Ceiling Fans

How did you hear about Parker House Cleaning?:

May we e-mail you special promotions and coupons?: (Please check Yes or No)
Yes No

Comments:

Parker House Cleaning is a division of Mountain Maids of Colorado
Copyright 2012 Mountain Maids of Colorado