Residential Lead Testing Interest Form
The Water Collaborative (TWC) is a regional leader in urban water management and climate adaptation strategies, dedicated to to better understand the lead and copper challenges in Orleans Parish. Lead pipes pose a significant public health risk due to their potential to contaminate drinking water, especially in cities like New Orleans with aging infrastructure and legacy pipelines. Our primary goal is to empower the community by sharing crucial insights into lead exposure and educating individuals on effective mitigation strategies.

We are actively seeking residents in Orleans Parish for free water quality testing starting May 2024. Please note that we are only able to test a limited number of homes. Before proceeding, please review the following requirements:
  • Must be an active resident of Orleans Parish.
  • Have or suspect you have a lead service line, particularly if it was built before 1988.
  • Provide consent for water sample collection, testing, and reporting.
  • Understand that water must sit for a minimum of 6 hours prior to sample collection. This includes not using any water, flushing, or running appliances beforehand.
  • Applicants must be present at the time of water collection.
  • Allow TWC Lead Fellows access to the property for sample collection purposes.
Review the full Participant Description to learn more study details.
If you have any questions or concerns, please contact Policy and Research Coordinator, Taya Fontenette (taya@nolawater.org).
Sign in to Google to save your progress. Learn more
Privacy Statement for Resident Data
All personal information provided in this form will be kept confidential and accessed only by authorized study personnel. Your data will not be shared with third parties without your explicit consent. Water testing results will be anonymized and aggregated for analysis, ensuring individual privacy. Your participation in The Water Collaborative's Lead Testing Study is voluntary, and you may withdraw at any time without penalty.

Name (First and Last) *
Email *
Phone Number *
Address (Street Address, Zip Code) *
What material is your home service line made of? *
What year was your home built? *
How would you describe the type of residence? *
Choose the option that best describes your current living situation in the home: *
Is your street currently undergoing any form of construction, such as street repair or meter replacements?
 *
How did you hear about this opportunity?
 *
Please share any questions or comments about the study or concerns you may have about your tap water.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of The Water Collaborative. Report Abuse
Google Forms