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MEDICAL CLINIC SANITIZATION & DISINFECTION

​Specialized Healthcare & Clinical Facility Disinfection
Compliant with OSHA, CDC, and EPA Hospital-Grade Standards
​Clinic / Medical Facility Name Primary Contact Person Phone Number E-mail Facilty Address
Facility Type
Urgent Care
Dental Office
Surgical Center
Out-Patient/Specialty Clinic
Diagnostics/Imaging Center
Clinical Zones
Exam Rooms
Procedure/Operating Room
Dental/Patient Bays
Recovery Rooms
Exam Room Qty Procedure/Surgical Room Qty Dental/Patient Bay Qty Recovery Room Qty
Common & Admin Areas
Waiting Room/Reception
Staff Breakroom/Kitchen
Administrative Offices
Restrooms
Administrative Office Qty Restroom Qty
Specialized Units
Diagnostic / X-Ray / MRI Lab
On-Site Testing / Lab Area
​Primary Reason for Service
Routine Terminal / Deep Clean Maintenance (Ongoing daily/weekly contract)
Infectious Outbreak Response (e.g., Norovirus, COVID-19, MRSA, C. diff)
Post-Renovation / New Unit Opening Clean (Dust mitigation & bio-decontamination)
Pre-Inspection / Compliance Audit Reset
​Required Service Timeline
Emergency / Rapid Outbreak Response (Within 12–24 Hours)
Standard Scheduled Onboarding / Deep Clean
Recurring After-Hours Maintenance
​Targeted Disinfection Methods
Electrostatic Fogging / Aerosolized Disinfection (360° coverage for non-porous clinical surfaces)
Hospital-Grade Manual Micro-Fiber Wipe-Down (Focus on patient touchpoints & equipment)
Combined Two-Step Protocol (Manual contact-surface wipe + full-room electrostatic spray)
​Product & Pathogen Requirements
EPA List N / List K Hospital Disinfectants (Effective against C. diff spores, MRSA, bloodborne pathogens)
Bleach-Free / Non-Corrosive Solutions (Safe for delicate electronic medical devices & screens)
Fragrance-Free / Low-VOC / Hypoallergenic (Safe for sensitive patient populations)
​Air Quality & Ventilation
HEPA Air Scrubbing / Negative Air Machine Setup
HVAC Intake / Return Surface Decontamination
​Preferred Cleaning Window:
After-Hours / Overnight (Preferred for zero patient disruption)
Weekend Execution
During Operating Hours (Requires silent, low-odor, discrete protocol)
​Facility Access Logistics
Keycard / FOB / Security Badge Provided
Lockbox / Key Code
Security Guard / Facility Manager Escort
Are site-specific PPE or immunization requirements needed for cleaning technicians?
Yes
No
​If Yes, list requirements (e.g., N95 masks, gowning, flu/vaccine verification): If There Is Any Other Information We Need To Know, Please Add Descriptions Below Submit