SERVICE REQUEST FORM

To help us process your service request promptly, please fill out the following form. We'll contact you within 24 hours and set up your call request.

Or, you may call our Service Department weekdays between 9:00 - 4:30 pm at 352-373-0612.

Florida Leisure Pool & Spa is committed to providing professional service to every swimming pool or spa owner and customer. We are industry-trained to service all pool and spa equipment, regardless of the builder or manufacturer.  By completing some additional information below, we will set you up with a qualified service technician to repair your swimming pool or spa.

* Required Field

*Customer First Name:
*Customer Last Name:
CUSTOMER'S EMAIL ADDRESS:
Home Phone:
Cell Phone:
Other Phone:
Address:
City:
*Zip code:
*Submitted By (name):
Submitted By (Company):
Pool , Spa or Hot Tub?:
Equipment Type:
*Date of Purchase or Installed Date? mm/dd/yy:
Manufacturer:
Model #:
Serial #:
*Problem / Complaint (Additional Comments):
Please enter the text shown in the graphic below
Text: