NATURALLY CLEAN LAFAYETTE LLC
Client Intake Form
Client Information
Name(s)
Service Address
Home Phone
Work Phone
Mobile Phone
Email
Access Information
Gate Code
Garage Code
Alarm Code
Door Code
Parking
Guest Wi-Fi Password
Other
Pets
Dogs
Names
Where they are kept
Friendly
Not Friendly
Special instructions
Cats
Names
Where they are kept
Friendly
Not Friendly
Special instructions
Waste Disposal
Trash Bag Location
Outdoor Garbage & Recycling Locations
Special instructions
Floor Cleaning
Preferred Cleaner
Vinegar/Water
Hardwood/Laminate Cleaner
Natural Cleaner
Any
Fragile Item(s)
Special Attention
Don't Touch
Damaged Items
Other
Household Information & Add-On Services (Fees may apply)
Organization Services
Linen Services (Standard)
Ceiling Wipe Down
Window Tracks
Laundry Services
Oven Cleaning
Dishwashing
Wipe Down Woodwork
Fridge/Freezer (Interior)
Interior Windows
Date & Time Preferences
Preferred Cleaning Day(s)
Preferred Cleaning Times
Signature
Typing your name constitutes an electronic signature.
Date
Submit