freewatertestfl.f.graphicwebdesigninc.com
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162.240.71.11
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URL:
https://freewatertestfl.f.graphicwebdesigninc.com/
Submission: On March 02 via api from US — Scanned from US
Submission: On March 02 via api from US — Scanned from US
Form analysis 1 forms found in the DOM
POST
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<h3 class="ninja-forms-mp-page-title">Schedule A Free In Home Consultation and Get Your Water Tested Today!</h3>
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<label for="ninja_forms_field_19" id="ninja_forms_field_19_label" class="">Best Time To Call: </label>
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<option value="Morning " selected="" style="">Morning </option>
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<h3 class="ninja-forms-mp-page-title">Select All The Problems You Are Having With Your Water</h3>
<h4 class="ninja-forms-field nf-desc" id="ninja_forms_field_22_div_wrap" style="" rel="22">Tap Water (Drinking & Cooking)</h4>
<div class="field-wrap checkbox-wrap label-right" id="ninja_forms_field_23_div_wrap" data-visible="1">
<input type="hidden" id="ninja_forms_field_23_type" value="checkbox">
<input id="" name="ninja_forms_field_23" type="hidden" value="unchecked"><input id="ninja_forms_field_23" name="ninja_forms_field_23" type="checkbox" class="ninja-forms-field " value="checked" rel="23"> <label for="ninja_forms_field_23"
id="ninja_forms_field_23_label" class="">Bad Taste </label>
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<div class="field-wrap checkbox-wrap label-right" id="ninja_forms_field_31_div_wrap" data-visible="1">
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<input id="" name="ninja_forms_field_31" type="hidden" value="unchecked"><input id="ninja_forms_field_31" name="ninja_forms_field_31" type="checkbox" class="ninja-forms-field " value="checked" rel="31"> <label for="ninja_forms_field_31"
id="ninja_forms_field_31_label" class="">Chlorine Odor </label>
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<div class="field-wrap checkbox-wrap label-right" id="ninja_forms_field_32_div_wrap" data-visible="1">
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<input id="" name="ninja_forms_field_32" type="hidden" value="unchecked"><input id="ninja_forms_field_32" name="ninja_forms_field_32" type="checkbox" class="ninja-forms-field " value="checked" rel="32"> <label for="ninja_forms_field_32"
id="ninja_forms_field_32_label" class="">Cloudy </label>
<div id="ninja_forms_field_32_error" style="display:none;" class="ninja-forms-field-error">
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<div class="field-wrap checkbox-wrap label-right" id="ninja_forms_field_33_div_wrap" data-visible="1">
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<input id="" name="ninja_forms_field_33" type="hidden" value="unchecked"><input id="ninja_forms_field_33" name="ninja_forms_field_33" type="checkbox" class="ninja-forms-field " value="checked" rel="33"> <label for="ninja_forms_field_33"
id="ninja_forms_field_33_label" class="">Fishy Odor </label>
<div id="ninja_forms_field_33_error" style="display:none;" class="ninja-forms-field-error">
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<div class="field-wrap checkbox-wrap label-right" id="ninja_forms_field_34_div_wrap" data-visible="1">
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<input id="" name="ninja_forms_field_34" type="hidden" value="unchecked"><input id="ninja_forms_field_34" name="ninja_forms_field_34" type="checkbox" class="ninja-forms-field " value="checked" rel="34"> <label for="ninja_forms_field_34"
id="ninja_forms_field_34_label" class="">Must Odor </label>
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<div class="field-wrap checkbox-wrap label-right" id="ninja_forms_field_35_div_wrap" data-visible="1">
<input type="hidden" id="ninja_forms_field_35_type" value="checkbox">
<input id="" name="ninja_forms_field_35" type="hidden" value="unchecked"><input id="ninja_forms_field_35" name="ninja_forms_field_35" type="checkbox" class="ninja-forms-field " value="checked" rel="35"> <label for="ninja_forms_field_35"
id="ninja_forms_field_35_label" class="">Off-Color </label>
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<div class="field-wrap checkbox-wrap label-right" id="ninja_forms_field_36_div_wrap" data-visible="1">
<input type="hidden" id="ninja_forms_field_36_type" value="checkbox">
<input id="" name="ninja_forms_field_36" type="hidden" value="unchecked"><input id="ninja_forms_field_36" name="ninja_forms_field_36" type="checkbox" class="ninja-forms-field " value="checked" rel="36"> <label for="ninja_forms_field_36"
id="ninja_forms_field_36_label" class="">Rotten Egg Odor </label>
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<h4 class="ninja-forms-field block nf-desc" id="ninja_forms_field_38_div_wrap" style="" rel="38">Laundry</h4>
<div class="field-wrap checkbox-wrap label-right" id="ninja_forms_field_40_div_wrap" data-visible="1">
<input type="hidden" id="ninja_forms_field_40_type" value="checkbox">
<input id="" name="ninja_forms_field_40" type="hidden" value="unchecked"><input id="ninja_forms_field_40" name="ninja_forms_field_40" type="checkbox" class="ninja-forms-field " value="checked" rel="40"> <label for="ninja_forms_field_40"
id="ninja_forms_field_40_label" class="">Excessive Soap Usage </label>
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<div class="field-wrap checkbox-wrap label-right" id="ninja_forms_field_41_div_wrap" data-visible="1">
<input type="hidden" id="ninja_forms_field_41_type" value="checkbox">
<input id="" name="ninja_forms_field_41" type="hidden" value="unchecked"><input id="ninja_forms_field_41" name="ninja_forms_field_41" type="checkbox" class="ninja-forms-field " value="checked" rel="41"> <label for="ninja_forms_field_41"
id="ninja_forms_field_41_label" class="">Lack Of Suds </label>
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<div class="field-wrap checkbox-wrap label-right" id="ninja_forms_field_42_div_wrap" data-visible="1">
<input type="hidden" id="ninja_forms_field_42_type" value="checkbox">
<input id="" name="ninja_forms_field_42" type="hidden" value="unchecked"><input id="ninja_forms_field_42" name="ninja_forms_field_42" type="checkbox" class="ninja-forms-field " value="checked" rel="42"> <label for="ninja_forms_field_42"
id="ninja_forms_field_42_label" class="">Scale Buildup </label>
<div id="ninja_forms_field_42_error" style="display:none;" class="ninja-forms-field-error">
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<div class="field-wrap checkbox-wrap label-right" id="ninja_forms_field_43_div_wrap" data-visible="1">
<input type="hidden" id="ninja_forms_field_43_type" value="checkbox">
<input id="" name="ninja_forms_field_43" type="hidden" value="unchecked"><input id="ninja_forms_field_43" name="ninja_forms_field_43" type="checkbox" class="ninja-forms-field " value="checked" rel="43"> <label for="ninja_forms_field_43"
id="ninja_forms_field_43_label" class="">Stiff Laundry </label>
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<div class="field-wrap checkbox-wrap label-right" id="ninja_forms_field_44_div_wrap" data-visible="1">
<input type="hidden" id="ninja_forms_field_44_type" value="checkbox">
<input id="" name="ninja_forms_field_44" type="hidden" value="unchecked"><input id="ninja_forms_field_44" name="ninja_forms_field_44" type="checkbox" class="ninja-forms-field " value="checked" rel="44"> <label for="ninja_forms_field_44"
id="ninja_forms_field_44_label" class="">Water Staining </label>
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<h4 class="ninja-forms-field nf-desc" id="ninja_forms_field_52_div_wrap" style="" rel="52">Kitchen Appliances</h4>
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<input type="hidden" id="ninja_forms_field_47_type" value="checkbox">
<input id="" name="ninja_forms_field_47" type="hidden" value="unchecked"><input id="ninja_forms_field_47" name="ninja_forms_field_47" type="checkbox" class="ninja-forms-field " value="checked" rel="47"> <label for="ninja_forms_field_47"
id="ninja_forms_field_47_label" class="">Cloudy Ice Cubes </label>
<div id="ninja_forms_field_47_error" style="display:none;" class="ninja-forms-field-error">
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<div class="field-wrap checkbox-wrap label-right" id="ninja_forms_field_48_div_wrap" data-visible="1">
<input type="hidden" id="ninja_forms_field_48_type" value="checkbox">
<input id="" name="ninja_forms_field_48" type="hidden" value="unchecked"><input id="ninja_forms_field_48" name="ninja_forms_field_48" type="checkbox" class="ninja-forms-field " value="checked" rel="48"> <label for="ninja_forms_field_48"
id="ninja_forms_field_48_label" class="">Scale Buildup </label>
<div id="ninja_forms_field_48_error" style="display:none;" class="ninja-forms-field-error">
</div>
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<div class="field-wrap checkbox-wrap label-right" id="ninja_forms_field_49_div_wrap" data-visible="1">
<input type="hidden" id="ninja_forms_field_49_type" value="checkbox">
<input id="" name="ninja_forms_field_49" type="hidden" value="unchecked"><input id="ninja_forms_field_49" name="ninja_forms_field_49" type="checkbox" class="ninja-forms-field " value="checked" rel="49"> <label for="ninja_forms_field_49"
id="ninja_forms_field_49_label" class="">Water Spotting </label>
<div id="ninja_forms_field_49_error" style="display:none;" class="ninja-forms-field-error">
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<div class="field-wrap checkbox-wrap label-right" id="ninja_forms_field_50_div_wrap" data-visible="1">
<input type="hidden" id="ninja_forms_field_50_type" value="checkbox">
<input id="" name="ninja_forms_field_50" type="hidden" value="unchecked"><input id="ninja_forms_field_50" name="ninja_forms_field_50" type="checkbox" class="ninja-forms-field " value="checked" rel="50"> <label for="ninja_forms_field_50"
id="ninja_forms_field_50_label" class="">Water Staining </label>
<div id="ninja_forms_field_50_error" style="display:none;" class="ninja-forms-field-error">
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<div class="field-wrap checkbox-wrap label-right" id="ninja_forms_field_51_div_wrap" data-visible="1">
<input type="hidden" id="ninja_forms_field_51_type" value="checkbox">
<input id="" name="ninja_forms_field_51" type="hidden" value="unchecked"><input id="ninja_forms_field_51" name="ninja_forms_field_51" type="checkbox" class="ninja-forms-field " value="checked" rel="51"> <label for="ninja_forms_field_51"
id="ninja_forms_field_51_label" class="">Frequent Dishwasher Repairs </label>
<div id="ninja_forms_field_51_error" style="display:none;" class="ninja-forms-field-error">
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<h4 class="ninja-forms-field nf-desc" id="ninja_forms_field_55_div_wrap" style="" rel="55">Shower & Bath</h4>
<div class="field-wrap checkbox-wrap label-right" id="ninja_forms_field_56_div_wrap" data-visible="1">
<input type="hidden" id="ninja_forms_field_56_type" value="checkbox">
<input id="" name="ninja_forms_field_56" type="hidden" value="unchecked"><input id="ninja_forms_field_56" name="ninja_forms_field_56" type="checkbox" class="ninja-forms-field " value="checked" rel="56"> <label for="ninja_forms_field_56"
id="ninja_forms_field_56_label" class="">Dull, Limp Hair </label>
<div id="ninja_forms_field_56_error" style="display:none;" class="ninja-forms-field-error">
</div>
</div>
<div class="field-wrap checkbox-wrap label-right" id="ninja_forms_field_57_div_wrap" data-visible="1">
<input type="hidden" id="ninja_forms_field_57_type" value="checkbox">
<input id="" name="ninja_forms_field_57" type="hidden" value="unchecked"><input id="ninja_forms_field_57" name="ninja_forms_field_57" type="checkbox" class="ninja-forms-field " value="checked" rel="57"> <label for="ninja_forms_field_57"
id="ninja_forms_field_57_label" class="">Dry Skin </label>
<div id="ninja_forms_field_57_error" style="display:none;" class="ninja-forms-field-error">
</div>
</div>
<div class="field-wrap checkbox-wrap label-right" id="ninja_forms_field_59_div_wrap" data-visible="1">
<input type="hidden" id="ninja_forms_field_59_type" value="checkbox">
<input id="" name="ninja_forms_field_59" type="hidden" value="unchecked"><input id="ninja_forms_field_59" name="ninja_forms_field_59" type="checkbox" class="ninja-forms-field " value="checked" rel="59"> <label for="ninja_forms_field_59"
id="ninja_forms_field_59_label" class="">Poor Lathering of Soaps & Shampoos </label>
<div id="ninja_forms_field_59_error" style="display:none;" class="ninja-forms-field-error">
</div>
</div>
<div class="field-wrap checkbox-wrap label-right" id="ninja_forms_field_60_div_wrap" data-visible="1">
<input type="hidden" id="ninja_forms_field_60_type" value="checkbox">
<input id="" name="ninja_forms_field_60" type="hidden" value="unchecked"><input id="ninja_forms_field_60" name="ninja_forms_field_60" type="checkbox" class="ninja-forms-field " value="checked" rel="60"> <label for="ninja_forms_field_60"
id="ninja_forms_field_60_label" class="">Checkbox </label>
<div id="ninja_forms_field_60_error" style="display:none;" class="ninja-forms-field-error">
</div>
</div>
<div class="field-wrap checkbox-wrap label-right" id="ninja_forms_field_61_div_wrap" data-visible="1">
<input type="hidden" id="ninja_forms_field_61_type" value="checkbox">
<input id="" name="ninja_forms_field_61" type="hidden" value="unchecked"><input id="ninja_forms_field_61" name="ninja_forms_field_61" type="checkbox" class="ninja-forms-field " value="checked" rel="61"> <label for="ninja_forms_field_61"
id="ninja_forms_field_61_label" class="">Soap Residue </label>
<div id="ninja_forms_field_61_error" style="display:none;" class="ninja-forms-field-error">
</div>
</div>
<div class="field-wrap checkbox-wrap label-right" id="ninja_forms_field_62_div_wrap" data-visible="1">
<input type="hidden" id="ninja_forms_field_62_type" value="checkbox">
<input id="" name="ninja_forms_field_62" type="hidden" value="unchecked"><input id="ninja_forms_field_62" name="ninja_forms_field_62" type="checkbox" class="ninja-forms-field " value="checked" rel="62"> <label for="ninja_forms_field_62"
id="ninja_forms_field_62_label" class="">Scale Buildup on Fixtures and Showerhead </label>
<div id="ninja_forms_field_62_error" style="display:none;" class="ninja-forms-field-error">
</div>
</div>
<div class="field-wrap checkbox-wrap label-right" id="ninja_forms_field_65_div_wrap" data-visible="1">
<input type="hidden" id="ninja_forms_field_65_type" value="checkbox">
<input id="" name="ninja_forms_field_65" type="hidden" value="unchecked"><input id="ninja_forms_field_65" name="ninja_forms_field_65" type="checkbox" class="ninja-forms-field " value="checked" rel="65"> <label for="ninja_forms_field_65"
id="ninja_forms_field_65_label" class="">Water Spotting </label>
<div id="ninja_forms_field_65_error" style="display:none;" class="ninja-forms-field-error">
</div>
</div>
<div class="field-wrap checkbox-wrap label-right" id="ninja_forms_field_63_div_wrap" data-visible="1">
<input type="hidden" id="ninja_forms_field_63_type" value="checkbox">
<input id="" name="ninja_forms_field_63" type="hidden" value="unchecked"><input id="ninja_forms_field_63" name="ninja_forms_field_63" type="checkbox" class="ninja-forms-field " value="checked" rel="63"> <label for="ninja_forms_field_63"
id="ninja_forms_field_63_label" class="">Water Staining </label>
<div id="ninja_forms_field_63_error" style="display:none;" class="ninja-forms-field-error">
</div>
</div>
<h4 class="ninja-forms-field nf-desc" id="ninja_forms_field_68_div_wrap" style="" rel="68">Specific Containment</h4>
<div class="field-wrap checkbox-wrap label-right" id="ninja_forms_field_69_div_wrap" data-visible="1">
<input type="hidden" id="ninja_forms_field_69_type" value="checkbox">
<input id="" name="ninja_forms_field_69" type="hidden" value="unchecked"><input id="ninja_forms_field_69" name="ninja_forms_field_69" type="checkbox" class="ninja-forms-field " value="checked" rel="69"> <label for="ninja_forms_field_69"
id="ninja_forms_field_69_label" class="">Arsenic </label>
<div id="ninja_forms_field_69_error" style="display:none;" class="ninja-forms-field-error">
</div>
</div>
<div class="field-wrap checkbox-wrap label-right" id="ninja_forms_field_70_div_wrap" data-visible="1">
<input type="hidden" id="ninja_forms_field_70_type" value="checkbox">
<input id="" name="ninja_forms_field_70" type="hidden" value="unchecked"><input id="ninja_forms_field_70" name="ninja_forms_field_70" type="checkbox" class="ninja-forms-field " value="checked" rel="70"> <label for="ninja_forms_field_70"
id="ninja_forms_field_70_label" class="">Chlorine </label>
<div id="ninja_forms_field_70_error" style="display:none;" class="ninja-forms-field-error">
</div>
</div>
<div class="field-wrap checkbox-wrap label-right" id="ninja_forms_field_71_div_wrap" data-visible="1">
<input type="hidden" id="ninja_forms_field_71_type" value="checkbox">
<input id="" name="ninja_forms_field_71" type="hidden" value="unchecked"><input id="ninja_forms_field_71" name="ninja_forms_field_71" type="checkbox" class="ninja-forms-field " value="checked" rel="71"> <label for="ninja_forms_field_71"
id="ninja_forms_field_71_label" class="">Cysts (Giardia, Cryptosporidum) </label>
<div id="ninja_forms_field_71_error" style="display:none;" class="ninja-forms-field-error">
</div>
</div>
<div class="field-wrap checkbox-wrap label-right" id="ninja_forms_field_72_div_wrap" data-visible="1">
<input type="hidden" id="ninja_forms_field_72_type" value="checkbox">
<input id="" name="ninja_forms_field_72" type="hidden" value="unchecked"><input id="ninja_forms_field_72" name="ninja_forms_field_72" type="checkbox" class="ninja-forms-field " value="checked" rel="72"> <label for="ninja_forms_field_72"
id="ninja_forms_field_72_label" class="">Fluoride </label>
<div id="ninja_forms_field_72_error" style="display:none;" class="ninja-forms-field-error">
</div>
</div>
<div class="field-wrap checkbox-wrap label-right" id="ninja_forms_field_73_div_wrap" data-visible="1">
<input type="hidden" id="ninja_forms_field_73_type" value="checkbox">
<input id="" name="ninja_forms_field_73" type="hidden" value="unchecked"><input id="ninja_forms_field_73" name="ninja_forms_field_73" type="checkbox" class="ninja-forms-field " value="checked" rel="73"> <label for="ninja_forms_field_73"
id="ninja_forms_field_73_label" class="">Heavy Metals </label>
<div id="ninja_forms_field_73_error" style="display:none;" class="ninja-forms-field-error">
</div>
</div>
<div class="field-wrap checkbox-wrap label-right" id="ninja_forms_field_74_div_wrap" data-visible="1">
<input type="hidden" id="ninja_forms_field_74_type" value="checkbox">
<input id="" name="ninja_forms_field_74" type="hidden" value="unchecked"><input id="ninja_forms_field_74" name="ninja_forms_field_74" type="checkbox" class="ninja-forms-field " value="checked" rel="74"> <label for="ninja_forms_field_74"
id="ninja_forms_field_74_label" class="">Nitrates </label>
<div id="ninja_forms_field_74_error" style="display:none;" class="ninja-forms-field-error">
</div>
</div>
<div class="field-wrap checkbox-wrap label-right" id="ninja_forms_field_75_div_wrap" data-visible="1">
<input type="hidden" id="ninja_forms_field_75_type" value="checkbox">
<input id="" name="ninja_forms_field_75" type="hidden" value="unchecked"><input id="ninja_forms_field_75" name="ninja_forms_field_75" type="checkbox" class="ninja-forms-field " value="checked" rel="75"> <label for="ninja_forms_field_75"
id="ninja_forms_field_75_label" class="">TDS </label>
<div id="ninja_forms_field_75_error" style="display:none;" class="ninja-forms-field-error">
</div>
</div>
<div class="field-wrap checkbox-wrap label-right" id="ninja_forms_field_76_div_wrap" data-visible="1">
<input type="hidden" id="ninja_forms_field_76_type" value="checkbox">
<input id="" name="ninja_forms_field_76" type="hidden" value="unchecked"><input id="ninja_forms_field_76" name="ninja_forms_field_76" type="checkbox" class="ninja-forms-field " value="checked" rel="76"> <label for="ninja_forms_field_76"
id="ninja_forms_field_76_label" class="">Turbidity </label>
<div id="ninja_forms_field_76_error" style="display:none;" class="ninja-forms-field-error">
</div>
</div>
<div class="field-wrap checkbox-wrap label-right" id="ninja_forms_field_78_div_wrap" data-visible="1">
<input type="hidden" id="ninja_forms_field_78_type" value="checkbox">
<input id="" name="ninja_forms_field_78" type="hidden" value="unchecked"><input id="ninja_forms_field_78" name="ninja_forms_field_78" type="checkbox" class="ninja-forms-field " value="checked" rel="78"> <label for="ninja_forms_field_78"
id="ninja_forms_field_78_label" class="">VOCs </label>
<div id="ninja_forms_field_78_error" style="display:none;" class="ninja-forms-field-error">
</div>
</div>
</div>
<div id="ninja_forms_form_5_mp_page_3" class="ninja-forms-form-5-mp-page ninja-forms-mp-page" style="display:none;" rel="3">
<h3 class="ninja-forms-mp-page-title">Details</h3>
<div class="field-wrap list-dropdown-wrap label-left form-control-wrap" id="ninja_forms_field_83_div_wrap" data-visible="1">
<input type="hidden" id="ninja_forms_field_83_type" value="list">
<input type="hidden" id="ninja_forms_field_83_list_type" value="dropdown">
<label for="ninja_forms_field_83" id="ninja_forms_field_83_label" class="">What source of water do you have? </label>
<select name="ninja_forms_field_83" id="ninja_forms_field_83" class="ninja-forms-field form-control" rel="83">
<option value="City/County" selected="" style="">City/County</option>
<option value="Community Well" style="">Community Well</option>
<option value="Private Well" style="">Private Well</option>
</select>
<div id="ninja_forms_field_83_error" style="display:none;" class="ninja-forms-field-error">
</div>
</div>
<div class="field-wrap list-dropdown-wrap label-left form-control-wrap" id="ninja_forms_field_84_div_wrap" data-visible="1">
<input type="hidden" id="ninja_forms_field_84_type" value="list">
<input type="hidden" id="ninja_forms_field_84_list_type" value="dropdown">
<label for="ninja_forms_field_84" id="ninja_forms_field_84_label" class="">Are you using filtration now? </label>
<select name="ninja_forms_field_84" id="ninja_forms_field_84" class="ninja-forms-field form-control" rel="84">
<option value="Yes" selected="" style="">Yes</option>
<option value="No" style="">No</option>
</select>
<div id="ninja_forms_field_84_error" style="display:none;" class="ninja-forms-field-error">
</div>
</div>
<div class="field-wrap list-dropdown-wrap label-left form-control-wrap" id="ninja_forms_field_85_div_wrap" data-visible="1">
<input type="hidden" id="ninja_forms_field_85_type" value="list">
<input type="hidden" id="ninja_forms_field_85_list_type" value="dropdown">
<label for="ninja_forms_field_85" id="ninja_forms_field_85_label" class="">Do you drink bottled water instead of tap? </label>
<select name="ninja_forms_field_85" id="ninja_forms_field_85" class="ninja-forms-field form-control" rel="85">
<option value="Sometimes" selected="" style="">Sometimes</option>
<option value="Always" style="">Always</option>
<option value="Never" style="">Never</option>
</select>
<div id="ninja_forms_field_85_error" style="display:none;" class="ninja-forms-field-error">
</div>
</div>
<div class="field-wrap list-dropdown-wrap label-left form-control-wrap" id="ninja_forms_field_86_div_wrap" data-visible="1">
<input type="hidden" id="ninja_forms_field_86_type" value="list">
<input type="hidden" id="ninja_forms_field_86_list_type" value="dropdown">
<label for="ninja_forms_field_86" id="ninja_forms_field_86_label" class="">Do You Own? </label>
<select name="ninja_forms_field_86" id="ninja_forms_field_86" class="ninja-forms-field form-control" rel="86">
<option value="Yes" selected="" style="">Yes</option>
<option value="No" style="">No</option>
</select>
<div id="ninja_forms_field_86_error" style="display:none;" class="ninja-forms-field-error">
</div>
</div>
<div class="field-wrap list-dropdown-wrap label-left form-control-wrap" id="ninja_forms_field_87_div_wrap" data-visible="1">
<input type="hidden" id="ninja_forms_field_87_type" value="list">
<input type="hidden" id="ninja_forms_field_87_list_type" value="dropdown">
<label for="ninja_forms_field_87" id="ninja_forms_field_87_label" class="">Do You Rent? </label>
<select name="ninja_forms_field_87" id="ninja_forms_field_87" class="ninja-forms-field form-control" rel="87">
<option value="Yes" selected="" style="">Yes</option>
<option value="No" style="">No</option>
</select>
<div id="ninja_forms_field_87_error" style="display:none;" class="ninja-forms-field-error">
</div>
</div>
</div>
<div id="ninja_forms_form_5_mp_page_4" class="ninja-forms-form-5-mp-page ninja-forms-mp-page" style="display:none;" rel="4">
<h3 class="ninja-forms-mp-page-title">Almost Complete!</h3>
<div class="ninja-forms-required-items">Fields marked with an <span class="ninja-forms-req-symbol">*</span> are required</div>
<div class="field-wrap checkbox-wrap label-right" id="ninja_forms_field_28_div_wrap" data-visible="1">
<input type="hidden" id="ninja_forms_field_28_type" value="checkbox">
<input id="" name="ninja_forms_field_28" type="hidden" value="unchecked"><input id="ninja_forms_field_28" name="ninja_forms_field_28" type="checkbox" class="ninja-forms-field ninja-forms-req" value="checked" rel="28"> <label
for="ninja_forms_field_28" id="ninja_forms_field_28_label" class="">Please contact me by telephone to setup my FREE IN HOME WATER TEST and if necessary to advise me of possible improvements to my water. I understand that this is a
complimentary test and there is no charge for the test. <span class="ninja-forms-req-symbol"><strong>*</strong></span> </label>
<div id="ninja_forms_field_28_error" style="display:none;" class="ninja-forms-field-error">
</div>
</div>
<div class="field-wrap submit-wrap label-above" id="ninja_forms_field_29_div_wrap" data-visible="1">
<input type="hidden" id="ninja_forms_field_29_type" value="submit">
<div id="nf_submit_5">
<input type="submit" name="_ninja_forms_field_29" class="ninja-forms-field " id="ninja_forms_field_29" value="Send" rel="29">
</div>
<div id="nf_processing_5" style="display:none;">
<input type="submit" name="_ninja_forms_field_29" class="ninja-forms-field " id="ninja_forms_field_29" value="Processing" rel="29" disabled="">
</div>
<div id="ninja_forms_field_29_error" style="display:none;" class="ninja-forms-field-error">
</div>
</div>
</div>
</div>
<input type="hidden" name="_current_page" value="1">
<div id="ninja_forms_form_5_mp_nav_wrap" class="ninja-forms-mp-nav-wrap">
<input type="submit" name="_prev" class="ninja-forms-mp-nav ninja-forms-mp-prev" id="ninja_forms_form_5_mp_prev" value="Previous" style="display:none;">
<input type="submit" name="_next" class="ninja-forms-mp-nav ninja-forms-mp-next" id="ninja_forms_form_5_mp_next" value="Next" style="">
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</form>Text Content
Skip to content (305) 363-6966 Toggle navigation FREE WATER TEST FLORIDA Water Purification and Testing * Contact * * * * If you are a human and are seeing this field, please leave it blank. SCHEDULE A FREE IN HOME CONSULTATION AND GET YOUR WATER TESTED TODAY! Best Time To Call: Morning Afternoon Evening SELECT ALL THE PROBLEMS YOU ARE HAVING WITH YOUR WATER TAP WATER (DRINKING & COOKING) Bad Taste Chlorine Odor Cloudy Fishy Odor Must Odor Off-Color Rotten Egg Odor LAUNDRY Excessive Soap Usage Lack Of Suds Scale Buildup Stiff Laundry Water Staining KITCHEN APPLIANCES Cloudy Ice Cubes Scale Buildup Water Spotting Water Staining Frequent Dishwasher Repairs SHOWER & BATH Dull, Limp Hair Dry Skin Poor Lathering of Soaps & Shampoos Checkbox Soap Residue Scale Buildup on Fixtures and Showerhead Water Spotting Water Staining SPECIFIC CONTAINMENT Arsenic Chlorine Cysts (Giardia, Cryptosporidum) Fluoride Heavy Metals Nitrates TDS Turbidity VOCs DETAILS What source of water do you have? City/County Community Well Private Well Are you using filtration now? Yes No Do you drink bottled water instead of tap? Sometimes Always Never Do You Own? Yes No Do You Rent? Yes No ALMOST COMPLETE! Fields marked with an * are required Please contact me by telephone to setup my FREE IN HOME WATER TEST and if necessary to advise me of possible improvements to my water. I understand that this is a complimentary test and there is no charge for the test. * 2016 FreeWaterTestFL.com - All Rights Reserved - This Free service is only available in Miami Dade County and Monroe County. SECONDARY MENU * *