Carpet Restoration Request Form

For best response please provide your needs below...

Serving Orange County, Los Angeles & Riverside County

Full Name:	Required
Address:
City, State,Zip:
Phone:	Required
Email:	Required

Which rooms need carpet cleaning?	Living room	Dinning room
	Bedroom(s) Qty.	Family room
	Stairs	Stair landing
	Bathroom(s) Qty.	office
Total square feet	sq.ft.
Please describe your home or apartment.	Home - single story Home - two stories Home - three stories or more Apartment - one bedroom Apartment - two bedroom Apatment - three bedroom or more
What type(s) of carpet need cleaning?	Plush (cut pile)	Berber or loop pile
	Wool	Synthetic
	All nautral fibers	Light color
	Other
Which problems or services will need special attention?	Oil or grease spots	Soiling spots
	Water spots	Food or liquid stains
	Pet stains	Rust spots
	Soil filteration	Odor elimination
	Stain Guard Protection	Other

Copyright © 2002 Imperial Carpet Care. All rights reserved.
Last modified: Wednesday August 14, 2002.