Contact Information

First Name

Last Name

Preferred Name

Email Address

Phone Number

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City / Neighbourhood

ZIP Code

About Your Home

Type of home

House

Apartment / condo

Townhouse

Other

Size of home

Studio or 1 bed

2 bedrooms

3 bedrooms

4 bedrooms

5+ bedrooms

Number of bathrooms

1 bathroom

2 bathrooms

3 bathrooms

4+ bathrooms

Does your home have any of the following? (check all that apply)

Pets

Young children

Elderly residents

Allergies in the household

Hardwood or delicate floors

High-traffic / heavy use areas

Lots of belongings or clutter

Fragile or antique items

Tell us anything important about your home

What You Need Cleaned

Type of clean

Standard recurring clean

Deep clean — thorough top to bottom

Move-in clean

Move-out clean

Post-renovation clean

One-time only

How often?

Twice a week

Weekly

Every two weeks

Monthly

One-time

Flexible / as needed

Areas needing most attention (check all that apply)

Kitchen

Bathrooms

Bedrooms

Living areas

Laundry

Windows

Fridge interior

Oven interior

Baseboards & detail cleaning

Home office

Outdoor areas

Garage

Specific requests — things to do, things to avoid, off-limit areas

Schedule & Access

Days that work best

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Flexible

Preferred time of day

Morning (8am–12pm)

Midday (12pm–2pm)

Afternoon (2pm–5pm)

Flexible

Will you be home during cleaning?

Yes — always home

No — cleaner will have access

Usually home but flexible

Prefer not to be home

How soon do you need this to start?

This week

Within 2–3 weeks

Within the next month

No rush — planning ahead

Products & Preferences

Product preference (check all that apply)

I provide all cleaning products

Cleaner should bring their own

Eco-friendly / green only

No bleach or harsh chemicals

No strong fragrances

No preference

What matters most in a cleaner? (check all that apply)

Attention to detail

Reliability and consistency

Comfortable around pets

Comfortable around children

Non-smoker

Brings own supplies and equipment

Discreet and respects privacy

Experience with similar homes

Describe your ideal cleaner

Compensation & Payment

Budget per visit

$100–$150

$150–$200

$200–$280

Open to discussion based on home size

Preferred payment method

W2 / Formal payroll

Cash

Zelle / Venmo

Open to discussing

Anything Else

Anything else you'd like us to know before we start looking

Signature & Agreement

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Signature (enter your full legal name)

Date

Home Cleaning Request in Chicago

Contact Information

About Your Home

What You Need Cleaned

Schedule & Access

Products & Preferences

Compensation & Payment

Anything Else

Signature & Agreement

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Home Cleaning Request in Chicago

Contact Information

About Your Home

What You Need Cleaned

Schedule & Access

Products & Preferences

Compensation & Payment

Anything Else

Signature & Agreement

Ready for steady support

If It’s Not a Fit, You’re Not Stuck