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The NikEra Company
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Service Request Intake Form
Client Information
First name
(Required)
Last name
(Required)
Email
(Required)
Phone
Address
Preferred Method of Contact
Phone
Email
Text
Best Time to Reach You:
Service Needs
What challenges are you currently facing with time, organization, or daily routine?
What type of support are you looking for? (Check all that apply)
Task & Schedule Management
Co-host (Turo, Airbnb, Vrbo etc.)
Cleaning Service
Listing Setup (Turn, Airbnb, Vrbo etc.)
House/Apartment Sitting
Process Automation (Small Business)
Other
How often would you like support?
One-time project
Weekly
Bi-weekly
Monthly
As needed
Service Desired Date and Time
Month
Day
Year
Time
:
Hours
Minutes
AM
Budget Range per month/session (optional): $
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