Medical Cleaning You Can Trust OSHA-compliant, hospital-grade cleaning for healthcare facilities. Infection control, terminal cleaning, and HEPA disinfection. GET A FAST & FREE QUOTE 1. FACILITY INFORMATION Facility Name * Facility Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Facility Type * Hospital Urgent Care Center Medical Clinic Dental Office Outpatient Surgery Center Chiropractic / Physical Therapy Veterinary Clinic Other Approximate Facility Size * Less than 1,000 sq. ft. 1,000 – 2,500 sq. ft. 2,500 – 5,000 sq. ft. 5,000 – 7,500 sq. ft. 7,500 – 10,000 sq. ft. 10,000 – 15,000 sq. ft. 15,000 – 20,000 sq. ft. 20,000 – 30,000 sq. ft. 30,000 – 50,000 sq. ft. 50,000+ sq. ft. 2. CLEANING NEEDS Which Areas Need Cleaning? * Check all that apply to ensure a customized cleaning plan. Exam Rooms Patient Rooms Operating Rooms Restrooms Waiting Areas Offices Laboratories Hallways & Common Areas Other Do you require terminal cleaning? * Terminal cleaning is a deep sanitization process required for surgical & high-risk areas. Yes No Preferred Cleaning Schedule * Choose a frequency that fits your facility’s needs. Daily Weekly Bi-Weekly Monthly One-time deep cleaning Emergency cleaning Do you have any special cleaning requirements? * If Yes, please describe. 3. CONTACT INFORMATION Contact Name * Phone Number * (###) ### #### Email Address * I agree to receive calls, text messages, or emails from Cleanic regarding my cleaning inquiry. I understand I can opt out at any time. Best Time to Contact You? * Morning (9 AM - 12 PM) Afternoon (12 PM - 4 PM) Evening (4 PM - 7 PM) Thank you!
