Client Name: _____________________________

 Form Client Refuses to sign: _____________________________________

 Cost: $___________ Was card charged? Yes / No

 How was the client charged? ______________________________ 

Date client was charged: _______________________ 

Date of Service agreement: __________________ 

Notes: 

Employee filling out form: ___________________________________

 Date: _______________________

 Signature:___________________________________

If you require our services, we invite you to reach out to us directly via phone OR by filling out the Service Form and utilizing our self-booking system.
Please note that this form cannot be printed as a legal document. For any agreements or forms, please get in touch with Sparkly Housekeepers. Thank You.