Thank you for your interest in Dial-A-Mop.  We will need some information to complete your estimate. The more information you complete on the form below will enable us to be more accurate with your estimate. Once you have completed the form click on the "SEND" buttom.  We will do our best to respond the same business day.  Freedom from housecleaning is a few clicks away! 

First Name: Last Name:

Service Address:

City:    State:   Zip Code:

Email:

How did you hear about us: Please Make A Selection Vehicle Signs Internet Google Internet Yahoo Internet Search SuperPages Yellow Pages Suburban Home & Garden Magazine Clipper Magazine ValPak Money Mailer Service Magic Merchant Circle Post Card Door Hanger Referral SuperTradeExchange Cleaning For A Reason

My daytime phone is: ( ) - -

My evening phone is: ( ) - -

Best time to contact me:  Choose Time Morning 8-11 Afternoon 1-4 Evening 6-8

How should we contact you: Please Contact Me By Daytime Telephone Evening Telephone Email

When do you need service? Please Select One ASAP Within Days Next Week Next Two Weeks No Rush Planning & Budgeting

Special Needs: None Allergies COPD Patient Other Please Make A Selection

This is my: Primary Residence  Rental Property

Type of Residence: Select Type Single Family Condo Townhome Twin/Duplex Apartment

Service Frequency: Select Frequency Top To Bottom Deluxe Weekly Cleanings Bi-weekly Cleanings Monthly Cleanings One Time Cleaning Move In Cleaning Move Out Cleaning Post Construction Cleaning Empty House Cleaning Occasional Cleaning Special Cleaning Green Cleaning Spring Cleaning Fall Cleaning Annual Cleaning Model Home Cleaning New Construction Phase Cleaning Windows ONLY Carpets ONLY Home Organization ONLY

Square footage of Home: Please Select One Less than 1000 1001 - 1400 1401 - 1800 1801 - 2300 2301 - 2600 2601 - 3000 3001 - 3500 3501 - 3900 3901 - 4400 4401 - 4800 4800 - Up

Number of levels?  Number of staircases?

Number of Occupants?   Number of pets?  

Number of Ceiling Fans?

Window Dressings:
   Draperies?   Yes No   How many?  
   Window Shades? Yes No  How many?  
       Types: Cellular Honeycomb Fabric
   Window Blinds?  Yes No   How many?  
          Types: Vinyl Aluminum Wood   Verticals
  Window Shutters? Yes No   How many?  
         Types: Plantation Shutters Stained Wood Shutters

Flooring:
    Carpeting?    Yes No    How many rooms?
        Types of carpeting:  Pile Shag  Berber   Other
    Hard Surface Flooring? Yes No How many rooms?
        Types of hard surface:  Hardwood Laminate  Pergo
              Bamboo Tile  Stone Marble Concrete
              Vinyl Rubber Other

Living Space & other rooms:
    Living Room:   Dining Room:  
     Family Room:   Great Room:  
     Library:   Office:  
     Sunroom:   Loft:    
     Foyer  Yes No
     Bonus Rooms:
     Basement: Please Select One None Finished Unfinished Partially Finished
     Laundry Room:

Kitchen:  
      Eat-in with table and chairs:    Yes No
      Breakfast/Morning Room:   Yes No  
      Pantry (walk-in): Yes No
      Island: Yes No
      Stainless Steel: Yes No
      Cabinetry: Please Select One None Wood Laminate Painted Other
      Counters: Please Select One None Ceramic Tile Laminate Formica Granite Corian Silestone Quartz Zodiaq Concrete Wood - Butcher Block Stainless Steel

Bedrooms:
       How many bedrooms? 0 1 2 3 4 5 6    
       Change linens? Please Select One None 1 Bed 2 Beds 3 Beds 4 Beds 5 Beds 6 Beds

Bathrooms:
       How many bathrooms? 0 1 1.5 2 2.5 3 3.5 4 4.5 5 6  
       Garden Tub / Jacuzzi: Please Select One None 1 2 3 4
       Glass Shower Doors Yes No ?     How many pairs? 0 1 2 3 4 5
       Change Towels? Yes No

Will you need your;  
      Refrigerator (inside hand washed):  Yes No
      Oven (inside): Yes No     Self Cleaning: Yes No

   Windows cleaned:  Yes No
     How many windows?
         Inside ONLY   Inside & Outside
              Types of windows: 
              Tilt-in (bottom only)  Tilt-in (top & bottom)
              Double-hung Bay/Bow Casement Palladian
              Gliders Picture Skylight     

    Carpets cleaned: Yes No

Have you ever had your home cleaned professionally?  Please Select One Yes No
  Please check all that apply;
      Service Individual  Other  This will be the first time

Please share with us your experience?
  Please Select One Terrible that's why I am contacting you Okay, not the best Very Good Excellent   

Please use this space for additions information you would
  like us to use to complete your estimate:
 

Shall we inform you of specials & discounts? Yes No

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Dial-A-Mop does not share client information.  Click here to read our full privacy policy.