Lead Sampling Registration Form for Childcare Facilities
Complete this form to request free lead sampling through the Larimer County Department of Health and Environment.
Name of Childcare Facility
Name of the person requesting lead sampling
Please enter a valid phone number.
Have you completed water sampling for lead at your facility in the past?
I don't Know
Do you know what year the building where the facility is located was built?
I don't know
Approximately what year was it built?
Should be Empty: