Legionella Supply Order Form
Use this form to order the appropriate bottles.
This order form is for non-water providers such as well owners, business owners, and realtors who want to test their drinking water. Non-water providers do not follow a water testing compliance schedule or have a public water system identification number (PWSID).

In observation of state holidays, the State Lab will not accept water samples on the following dates:
  • Monday, Jan. 20, 2025
  • Monday, Feb. 17, 2025  
  • Monday, May 26, 2025
  • Thursday, June 19, 2025
  • Friday, July 4, 2025
  • Monday, Sept. 1, 2025 
  • Monday, Oct. 6, 2025 
  • Tuesday, Nov. 11, 2025
  • Thursday, Nov. 27, 2025
  • Thursday, Dec. 25, 2025   
Do not send samples via mail or third party carrier on the business day before the holidays listed above, or risk having to recollect samples.

With every order, the State Lab will send one requisition form per sample requested.

Payment for water testing is due at the time of water sample submission via drop off or mail.
The CDPHE courier service does not pick up at residential addresses for water testing. 
  • Contact your local public health agency to find out if it is an option to leave samples for couriers at their facility.
The State lab will not ship supplies for more than one sampling event at a time. A sampling event is all of the samples that will be collected on one day. The state lab will not ship to an address that you are not affiliated with. The only pick up location for State Lab orders is 8100 E Lowry Blvd, Denver, CO 80230. 

CDPHE will send a submission receipt to the email provided below.
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E-Mail-Adresse *
Are you a current customer? *
Customer/ Contact Name *
Facility or business name (if applicable)
Customer phone number *
How many potable water sources are you testing? (E.G. a  domestic water faucet, shower, water heater). If none, enter N/A. *
How many non-potable water sources are you testing? (E.G. a cooling tower reservoir, hot tub, pool). If none, enter N/A. *
How many biofilm sources are you testing? (E.G. a swab taken from a pool water line). If none, enter N/A. *
Each kit is provided with 1 sodium thiosulfate dropper bottle, which must be added to each sample at collection.  This chemical inactivates any remaining disinfectant in the water, to prevent bacteria from being killed during transport to the lab

By checking "yes" you acknowledge that you understand these requirements are necessary for accurate testing of the sample. *
What date do you expect to return these kits to CSPHL?

Please note, the lab requires a minimum of 7 days notice prior to submitting samples for this testing. *
Datum
Do you plan to pick up these supplies at the state lab? *
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Dieses Formular wurde bei State.co.us Executive Branch erstellt.

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