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Safe Shine: 15 Window Panels for $149 – Survey Form

How Many Window Panels Do You Need Cleaned? *

15 Panels (Standard Service - $149)

Other

If Other, Please Specify:

Type of Windows *

Standard Glass Windows

Sliding Glass Doors

Screens

Tinted Windows

Other

If Other, please specify:

Window Condition

Lightly Soiled (General dust and smudges)

Moderately Soiled (Some buildup or water stains)

Heavily Soiled (Stubborn stains, mold, or hard water buildup)

Not Sure

If not sure, Describe it here.

Preferred Cleaning Time *

Morning

Afternoon

Weekend

No Preference

Contact Details

First Name *

Last Name *

Email *

Phone *

Street Address

City

State

Country

Country

Postal code

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