Clients Name: 

Clients Address:

 Date Of Service: 

Employee Name: 

Explain what happened: 

List the items that have been damaged Make sure to take Pictures!!!!!! 

Employee Sign Date: 

Time:

 ...Office.... 

Manager Sign: 

Date:

 Was Client notified? Yes/ No

 Sparkly Housekeepers LLC

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.