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Rug Cleaning-Dyeing Intake Form

Rug Cleaning-Dyeing Intake Form

Name *

First

Last

Email to send you your Appt time *

Your Street Address (required) *

Your City (required) *

Your Zip (required) *

Cell Phone # and Work or Home # (required) *

Who Are You?

I'm the Homeowner
I'm Renting
Contractor/Cleaning Company
Commercial Client

What type of Service(s) do you need? (Choose ALL that apply)

Rug Cleaning
Bleach Spot Repair/Rug Dyeing
Tough Stain Removal
Pet Urine or Odor Removal
Fringe Repair
Rug Repair
Other

What Size Are Your Rugs? AND Quantity?

example: I have (1) 9 X 12 & (2) 5 x 8 rugs to be cleaned.

What is the fiber type of Each Rug- (Check Tag)

Wool Rug
Polypropylene Rug
Viscose blend Rug
Other/Unknown

Please Select Cause of Damage:

Bleach
Pet Urine
Toilet Bowl Cleaner
Resolve-Folex/Other Similar Spot Cleaning Chemical
Wine/Coffee/Dirt/Food/Grease
Other or Unknown Stain

After Bleach Spot, did you put a chemical on it yourself?

Yes, I tried to Fix It myself
No, After bleach spot, I haven't touched it

If Yes, what chemical(s) did you put in the carpet that still remain?

Is Your Rug Clean or Dirty?

Dirty Rug
Clean Rug
It Looks OK but it's been awhile

1st & 2nd Choice For Appt: Date & Time

please select your 1st & 2nd option so we can accomodate you if at all possible

Is there anything you specifically want to ask us or Additional info to tell us?

FINAL INSTRUCTIONS: (1) We Need a picture of the entire rug with the Urine/bleach spots/damage in it. Send each rug separately and each individual damage/spot in that rug separately. (2) We Need a closeup with a pen next to the damaged area to determine scope & size of spots (4) If Applicable, Try to count each spot(s)

Yes, I texted them to (855) 723-3022
Yes, I uploaded them here below under 'File Upload'
No, I did not
I emailed them instead

File Upload

Click or drag files to this area to upload. You can upload up to 20 files.

Rug Cleaning-Dyeing Intake Form was last modified: March 2nd, 2024 by admin

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