Pitcher and/or Filter Replacement Request

Please fill out this form if your home is enrolled in the Lead Reduction Program and you need a new and/or replacement water pitcher or filter certified to remove lead from drinking water. Complete all fields and allow 10-15 business days for shipping. Please use filtered water for drinking, cooking and preparing infant formula until six months after your service line is replaced.

Contact Information

First Name*:

Last Name*:

Phone Number*:

Email Address*:

Confirm Email Address*:

Property Information

Street Address*:

Unit/Apartment # (if applicable)

City*:

Zip Code*:

Please check inventory map to confirm that your address is in the Lead Reduction Program.

I have checked the inventory map to confirm that my address is in the Lead Reduction Program*:

Is the property address the same as the delivery address?*
Yes No

Is this a home built in 1983-1987?*

Is this a School/Daycare/Religious facility?*

Are there children < 24 months old or expecting mothers at this location?*

What needs to be replaced?*

*As part of the Lead Reduction Program, the Colorado Department of Public Health and Environment and the Environmental Protection Agency require Denver Water to report specifics related to why a customer is opting out of the filter program and if that customer has another means of obtaining filtered water.

Replacement Pitcher and/or Filter Request Form

Contact Information

Property Information