Cleaning Form for New and Current Clients
Please provide the information with an *
Fist Name:*
Last Name:*
Phone Number:*:
Cell Number::
Address:
City:
State:
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Texas
Utah
Virginia
Vermont
Washington
Wisconsin
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Wyoming
Zip Code:
E-mail:
Date of Service:
Month
January
February
March
April
May
June
July
August
September
October
November
December
Day
1
2
3
4
5
6
7
8
9
10
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20
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Year
2004
2005
2006
2007
2008
2009
2010
Do the same service every:
Please choose
One time
Once every week
Twice every week
Every two weeks
Every 3 weeks
Once a month
I let you know every time
Kitchen & Breackfast Cleaning check List
Wipe down the kitchen table & Chairs, dust hanging lights.
Clean spills from fronts of cabinets.
Counters cleaned - everything moved.
Clean top of fridge and front if possible.
Clean inside/outside of microwave.
Scrub sink, rinse and polish chrome.
Remove drip pans and rins from stove and clean.
Clean window over sink, dust blinds and sill.
Clean under drip pans, remove grill and clean under.
Cobwebs (check lights), baseboards & edge as needed.
Clean and polish stove top, front and control panel.
Clean glass doors and dust blinds.
Clean and polish hood vent.
Empty garbage
Clean and polish front of dishwasher and oven.
Vacuum, getting all corners & edges.
Clean and polish front of trash compactor.
Mop floors.
Please check the rooms you need service: Entryway, Living, Family, Dining, Office & Bonus Rooms/Other
Dust furniture, lamps and lampshades.
Entryway/ Foyer
Living Room
Family Room
Dining Room
Office & bonus room/Other
Dust woodwork, knickknacks and shelves.
Entryway/ Foyer
Living Room
Family Room
Dining Room
Office & bonus room/Other
Dust window sills, blinds and pictures.
Entryway/ Foyer
Living Room
Family Room
Dining Room
Office & bonus room/Other
Polish glass furniture, dust chair rails and hanging lights.
Entryway/ Foyer
Living Room
Family Room
Dining Room
Office & bonus room/Other
Cobweb (check lights), baseboards and edges as needed.
Entryway/ Foyer
Living Room
Family Room
Dining Room
Office & bonus room/Other
Vacuum, sweep floors.
Entryway/ Foyer
Living Room
Family Room
Dining Room
Office & bonus room/Other
Mop floors.
Entryway/ Foyer
Living Room
Family Room
Dining Room
Office & bonus room/Other
Please provided any additional information or tasks that you would need us to do:
Bedrooms Please check the rooms that you need services
Make bed, change linens (if provide)
Master Bedroom
Room 1
Room 2
Room 3
Room 4
Dust furniture, woodwork, lamps & lampshades
Master Bedroom
Room 1
Room 2
Room 3
Room 4
Dust knicknacks & shelves
Master Bedroom
Room 1
Room 2
Room 3
Room 4
Dust window sills, blinds & pictures
Master Bedroom
Room 1
Room 2
Room 3
Room 4
Polish glass furniture & dust doors
Master Bedroom
Room 1
Room 2
Room 3
Room 4
Cobweb (check lights), dust visible baseboards and edges as needed
Master Bedroom
Room 1
Room 2
Room 3
Room 4
Vacuum/sweep floors
Master Bedroom
Room 1
Room 2
Room 3
Room 4
Mop floors.
Master Bedroom
Room 1
Room 2
Room 3
Room 4
Please provided any additional information or tasks that you would need us to do:
Bathrooms Please check the bathrooms that you need services. If you have a 1/2 bathroom consider it as 1 full bathroom
Scrub shower floor, walls and grout with brush
Master Bathroom
Bathroom 1
Bathroom 2
Bathroom 3
Bathroom 4
Scrub shower door, tracks and glass. (in/out)
Master Bathroom
Bathroom 1
Bathroom 2
Bathroom 3
Bathroom 4
Scrub tub.
Master Bathroom
Bathroom 1
Bathroom 2
Bathroom 3
Bathroom 4
Squeegee glass and polish chrome.
Master Bathroom
Bathroom 1
Bathroom 2
Bathroom 3
Bathroom 4
Scrub sink, counter, soap dish and dry sink .
Master Bathroom
Bathroom 1
Bathroom 2
Bathroom 3
Bathroom 4
Scrub all inside and outside surfaces of toilet.
Master Bathroom
Bathroom 1
Bathroom 2
Bathroom 3
Bathroom 4
Clean light fixture, polish mirrors and chrome.
Master Bathroom
Bathroom 1
Bathroom 2
Bathroom 3
Bathroom 4
Dust towel racks, toilet paper holders and shelves.
Master Bathroom
Bathroom 1
Bathroom 2
Bathroom 3
Bathroom 4
Remove cobwebs and dust pictues (lights) .
Master Bathroom
Bathroom 1
Bathroom 2
Bathroom 3
Bathroom 4
Empty garbage.
Master Bathroom
Bathroom 1
Bathroom 2
Bathroom 3
Bathroom 4
Vacuum or sweep floor.
Master Bathroom
Bathroom 1
Bathroom 2
Bathroom 3
Bathroom 4
Scrub floor and wipe down baseboards
Master Bathroom
Bathroom 1
Bathroom 2
Bathroom 3
Bathroom 4
Please provided any additional information or tasks that you would need us to do:
Laundry/Utility Room
Hallways/Stairs
Wipe down machines
Dust woodwork & furniture
Scrub sink and counter
Dust railing & banisters
Polish chrome and dry sink
Dust window sills, blinds & picture
Wipe down woodwork and open shelves
Dust visible baseboards, cobweb & edge as needed.
Dust blinds and sill
Vacuum/sweep & or mop.
Remove any cobwebs
Empty garbage
Move clutter off floor
Vacuum around machines
Edge as needed, getting all corners
Clean/dust baseboards and mop
Comments or Questions:
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