Application for Lead Testing in Elementary Schools or Child Care Facilities

Complete a form for each Childcare Facility or Elementary School requesting the testing for lead. For assistance, contact kathy.mcfarland@arkansas.gov or call 501-661-2256.

Name of Facility
Type of Facility
Number of Students Served by Facility Local Education Agency (LEA) number or Facility ID Water System

Address of Facility

Street Address
City
Zip code
Year Facility Constructed

Contact Information

Name (Person responsible for collecting samples or accessing collection site)
Email
Phone
Arkansas Department of Health
© 2017 Arkansas Department of Health. All Rights Reserved. | www.healthy.arkansas.gov
4815 W. Markham, Little Rock, AR 72205-3867 | 1-800-462-0599
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