Intake Form — Local Connections

Client Intake Form

This is not a commitment form! We only ask you to answer these questions so that we can address your home & property request accurately.

Thank you so much for taking the time to complete!

What services are you interested in?

Are you the owner of the property?

Is this a full time residence or vacation home?

If cleaning, what is the square footage of area being cleaned? (for pricing purposes)

If known, please list the initial date you would like the service performed on

MM

DD

YYYY

May we use photos of your property for social media/marketing purposes?

Would you like to receive appointment reminders?

Please inform us of any special requests or questions

Personal Information

Name

First Name

Last Name

Email

Phone

(###)

###

####

What is the best way to reach you?

Address:

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Is this residence your mailing address?

If not, please list your mailing address:

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country