ALABAMA DEPARTMENT of PUBLIC HEALTH
 
Form to Request Free Radon Testing Kits

Enter the information requested below to receive your free radon testing kit. By providing your e-mail address below, you agree to receive email follow-up reminder(s) to use the radon test kit.

* First Name:

* Last Name:

* E-mail Address:




 

* Please check if you acknowledge the following Return Notice below.

Notice!
Return shipping is not included. The test will have to be sent First Class mail to the lab at a cost of almost $5.00.
 




 

Shipping Information

* Address:

* City:

* State


* Zip Code:

* Where did you hear about requesting your free test kit?


Other (Specify):