After making your selections, please click the Submit button at the bottom of the page, or print this form and fax to 804-864-7723 or mail it to Lead-Safe Virginia, Virginia Department of Health, P.O. Box 2448 Richmond, VA 23218.
Click here for a PDF version of the Material Request Form. ![]()
Lead-Safe Virginia
P.O. Box 2448
Richmond, VA 23218
Toll free 877-668-7987
(Within Virginia) or (804) 864-7698
Fax: (804) 864-7723
National Lead Information Center 1-800-424-5323