Client Intake From – Kingdom Professional Cleaning Services, LLC

Client Intake Form (#999)

First Name

Last Name

Business Name (if applicable):

Phone Number

Preferred Method of Contact:

Phone

Text

SECTION 2: SERVICE LOCATION

Address Line 1

Address Line 2

City

State

Zip Code

Country

Billing Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Square Footage (approx.):

Multiselect

Number of Levels:

One

Two

Three

Number of Bedrooms:

Number of Bathrooms:

Pets on Property?

Yes

SECTION 4: REQUESTED SERVICES (Check all that apply) Standard Cleaning

Dusting (surfaces, baseboards, vents)

Vacuuming & Mopping

Kitchen Cleaning

Bathroom Sanitization

Trash Removal

Deep Cleaning (Check all that apply)

Heavy buildup removal

Inside appliances (oven, fridge, microwave)

Detailed baseboards & trim

Wall spot cleaning

Preferred Time Window:

Morning

Afternoon

Evening

SECTION 7: SUPPLIES & PREFERENCES: Cleaning Supplies:

Client prefers company-provided supplies

Client will provide supplies

Product Preferences:

Standard

Eco-Friendly / Green Cleaning

Fragrance-Free

Special Entry Instructions:

Allergies or Sensitivities we should know about?

SECTION 8: CONDITION DISCLOSURE: Please disclose any known issues to ensure safety and accurate service:

Mold

Biohazard / Bodily Fluids

Pest Issues

Hoarding Conditions

Heavy Grease or Build-Up

Water Damage

Other

SECTION 9: PHOTOS (OPTIONAL BUT RECOMMENDED) Clients may upload photos or videos of the space to assist with accurate estimates.

Photos Provided

Photos to be sent separately

Payment Method Accepted:

Credit/Debit Card

Invoice

Cash (where applicable)

Payment is due according to the agreed service terms. Late cancellations may be subject to a fee.

SECTION 11: AGREEMENT & ACKNOWLEDGMENT Please read and acknowledge:

I understand that pricing is based on the information provided and may change if actual conditions differ.

I understand Kingdom Professional Cleaning Services is not responsible for pre-existing damage.

I agree to provide safe access to the property during scheduled services.

Client Signature:

Date / Time

Assigned Team

Estimated Time:

Quoted Price

Notes