RTI CleanPlus

Looking to test beer or water for PFAS? Contact us today to receive a testing kit.

PFAS Testing Intake Form

Welcome to RTI CleanPlus PFAS testing. Please fill out the form below to receive your PFAS testing kit.

How Our Process Works

Before we can send you a PFAS testing kit, we need some information first. Here's how it works:

Fill out the form below.
We follow up to confirm details.
We send you a link to complete payment.
We ship you a sampling kit.
You collect samples and ship back to us.
We provide you results and guidance on how to eliminate exposure.

If you have any questions, you can reach us at rticleanplus@rti.org or 855-997-2864.

Account Information

Provide details to set up your account.

Name*

Enter the name of the account holder

Email*

Enter an email address for the account holder. You will use this email to login and receive notifications.

Kit Information

Provide the name of the facility where samples will be taken (e.g., Palm Beach Resort, Pat's Brewing).

Site Name*

Provide the facility name.

Site Address*

Enter the facility address. This will be the shipping address for the sampling kit.

Address Details

Enter specific details of the site address (e.g., Bay 1, Door 2, Apt 3).

City*

State*

ZIP Code*

Site Contact

We will use this information to address your sampling kit. The information provided should contain the contact information for who will be receiving the kit.

Contact Name*

Enter the name of the person who will be receiving the kit.

Contact Phone Number*

Enter the phone number of the person who will be receiving the kit.

Sample Information

For "Location of Sample," describe where the sample was collected. If it was a tap or spigot, you might say "kitchen tap" or "source water tap." If it came from a can of beer, simply say "canned beer." If it is beer or water sampled at some point in the middle of the production process, describe it however makes sense to you.

For "Type of Sample," describe the type of liquid in the sample. Some examples are "source water," "drinking water," or "finished water." If it is beer, include the type or style. For example, "IPA beer," or "lager."

Table 1: Enter the locations and types of samples (maximum of 16).

Location of Sample

Type

Add Row