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Type of Leather:
Protected
Analine
Nubuck
Suade
Unknown
Furniture Type:
Sofa (Two or Three cushions)
Love Seat
Chair
Recliner
Kitchen Chair
Dining Room Chair
Loose Back Pillows?  
Yes
No
Throw Pillows?  
Yes
No
If Yes How Many?
How many?
Seat Only
Seat and Back
How Old?
Has it ever been professionally cleaned?
Yes
No If yes, how Long Ago?
If yes, were you satisfied? (Please Explain)
Are there any stains?
Yes
No
If yes please select which stains:
Ink
Paint
Make Up
Juice
Wine
Other (specify)
Are there any Pet Odors?
Yes
No
If yes please specify:
Would you like protectant applied?
Yes
No
(Protectant keeps spots from becoming permanent stains)
*
Name:
Address:
*
Phone:
*
Best Time To Call:
Additional Notes:
Starred Items are required
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