Customers of the following water districts may request a free water test kit. The Leadline staff may call you to follow-up on your online request.

If your water provider is not listed, call your provider directly and ask them about lead testing for your water. You can also call analytical labs in your area to find out if they provide lead-in-water testing.

Water Test Kit Instructions

First name:

Last name:

Address:

City:

State:

Zip:

Phone:

Email address:

How did you hear about us?: Please SelectWater brochure/water billWater ProviderWater Quality ReportMedical ProviderWebsiteEmailNews MediaFriend (word-of-mouth)Other

Please specify other:

Water district: Please SelectPortland Bureau of WaterBurlington Water DistrictGreshamPalatine Hill Water DistrictRaleigh Water DistrictRockwood Water DistrictCity of SherwoodCity of TigardCity of TualatinTualatin Valley Water DistrictValley View Water DistrictWest Slope Water DistrictUnknown

What year was your home built?:

Are there children 6 years of age or younger living in the home?:

Yes

No

Are there pregnant women living in the home?:

Yes

No

Would you like us to call you?:

Yes

No

Comment:

Word verification: * (verify using audio)

Type the characters you see in the picture above; if you can't read them, submit the form and a new image will be generated. Not case sensitive.