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:

* Email 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

For Alabama households only.

* Physical Address:
  (No P.O. Boxes)

* City:

* State:

* Zip Code:

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


Other: