green shield

test results are sent on-time or the next kit is FREE

green shield

Register Kit

Please fill out the form below so that we can register your test kit.

Please indicate place of purchase:

Please choose kit identification:

Sample Collection Date:

Sample Collection Time:

Sample Location (sink, outdoor faucet, etc.):

First Name:

Last Name:

Street Address:



Zip Code:

Email Address:

Phone Number:

Additional Info (to be noted on your analytical report):