• Contact information

  • Format: (000) 000-0000.

  • Property information

  • Address where sample will be taken (must be within Denver Water’s service area).

  • Property type*
  • Has Denver Water replaced all or part of the home's service line?*
  • Does the home's service line contain lead?*
  • Have there been any recent plumbing upgrades?*
  • Do you use any devices that filter your water?*
  • Select the faucet location where samples will be taken.*
  • Select the floor level where sample will be taken.*
  • Infant information

  • Are you expecting, or have a formula-fed infant under the age of 24 months?*
  • If you are having difficulties submitting the form, please fill out this alternative. Sorry for the inconvenience.

    If you need assistance filling out this form please call our Customer Care center at 303-893-2444.

  • Should be Empty: