Dragonfly Cleaning Request Form
Today’s Date ________________________________________________
Client’s Name ________________________________________________
Phone ______________________________________________________
Address _____________________________________________________
Email _______________________________________________________
Square Footage of Your Home ___________________________________
# of Bedrooms ________________________________________________
# of Bathrooms _______________________________________________
Directions/Notes ______________________________________________
Pets ________________________________________________________
Special Instructions ____________________________________________
____________________________________________________________
Cleaning Day ______________ Time _________________________
Frequency of Service (circle one)
Weekly Bi-Monthly Monthly One-Time
Type of Service (circle all that apply)
Residential Spring Clean Move In/Out Office Organic
Extras
- Organic Cleaning Products~$5.00
- Floor Cleaning Only~$50-up
- Organizing Prices Starting at $45 an area
Flittering about in Austin, Dripping Springs, Oak Hill, Steiner Ranch, Lakeway, Bastrop
512-659-1040 • Ashley@dragonflyclean.com
Committed to Giving our Customers a “Personalized Service” 7 Days a Week
Owned and Operated by Ms. Barger, a former corporate dynamo
who LOVES to make people smile with a sparkling clean and tidy Home!
WE ARE BONDED AND INSURED!!!

