Service 
Plus Form
In an effort to better pinpoint your housekeeping needs, we provide you with the option of Service Plus. Simply fill out this form, click on the 'Submit Form' button, and it will be part of your permanent record with us. |
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| Name |
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| Street |
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| City |
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| Zip |
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| E-mail |
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| H Phone |
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| W Phone |
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| C Phone |
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| 1) Have you had housekeeping help previously?
Yes
No |
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| 2) What is the approximate size of your home? |
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Under 2000 sq ft
2000-2500 sq ft
2500-3000 sq ft |
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3000-3500 sq ft
3000-3500 sq ft
over 3500 sq ft |
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| 3) What kind of service are you interested in? |
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Weekly
Every Two Weeks
One Time
Spring Clean |
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Move-in/Move-out
Other (carpets, windows, etc) |
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| 4) Have you had any problems with previous housekeepers? If so, please indicate the ones you found most difficult: |
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Unreliable 
Untrustworthy |
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Arrived late
Poor attitude |
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Sloppy work
Left early |
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Didn't follow directions
High turnover |
| Other:
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| 5) List specific item, if any, that previous housekeepers have missed or cleaned poorly: |
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| 6) If you could choose one thing that says 'clean house' to you, what would it be? |
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| 7) In case everything can't be finished in the time scheduled, what are your priorities? |
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| 8) Indicate in order of priority the characteristics of a housekeeper that are most important to you: (1 - 8) |
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Follows my directions |
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Self-directed |
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Punctual |
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Dependable |
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Long-term commitment |
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Fluent in English |
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Friendly |
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Businesslike |
| Other:
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| 9) List in order of preference, the day and time you would like service. |
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Mon |
Tues |
Wed |
Thurs |
Fri |
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Morning
Afternoon |
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Doesn't matter |
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| 10) Is there any other information you would like to have as part of your permanent record with us? |
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| 11) Would you like to receive extra brochures for friends? |
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Yes
No If so, how many?
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