Application for Long-Term Rental Service

Get a long term service, by opening an new account in 3 steps.

Complete all steps 1, 2 and 3. (Click on the Orange button tabs below)

To have a helium service at your business location, to get refills and exchange tanks every time when you need it. You need to open a business service account by submitting all required documents, forms and applications. you can find all the requirements at this page. open an account for long term services with us.

File Uploader

Please upload your files in the format listed below. to choose more then one file, hold control key on your keyboard.

Business account long-term rental service form

Please complete this online form first, all field with the. star * are required, to submit this form successfully.


* Billing info, name & address (needs to match your credit card)
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* Delivery info, name & address (needs to match your credit card)
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For full review for our terms of service click here

Recurring Payments authorization form

Fill out all the information required in the document below save it, download it to your device and sign it.

Afterwards send it back to us via one of the options available to you:

1. File uploader – located on the top section of this page.

2. Email it: [email protected]

3. Fax it: (718) 787-4480.

Click on the icon to download the “recurring payment form as blank PDF file to your device or computer to fill it up manually.

Copy of your if identification card

Please send a clear copy frons and back of your driver’s license or legal issued government ID.

You can use “file uploader” section located on the top of this page to upload all your files from your computer or device or simply send an email with all files as an attachments to: [email protected]

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Quick Contact Form

Expect for our response no later than 24 hours or sooner. If you have any question about our product or service feel free to write your question on the section below.