Long Island Pool & Patio is licensed, insured and provides many different pool services for inground swimming pools. Some of the services that are provided include: opening and closing, liner replacement, leak detection, heating systems, and other general services. Fill out the form below to book a services today.

Date:

*Pool Owner Name:

Name of Cardholder:

Credit Card Company:



Credit Card Number:

Expiration Date:

CCID#

Amount To Apply:

$

Keep Card On File



Address:

City:

State:

Zip:

Home Phone:

*Email Address:

Billing Address:

City:

State:

Zip:

 

By clicking the submit button, I authorize Long Island Pool and Patio to run the above named credit card for payment of services and/or chemicals for my swimming pool.

 

If you would rather fax your credit card information, please click below:

Credit Card Authorization Form