Contact SFDPH Environmental Health personnel to estimate your safe chemical exposure level at (415) 554-2500 (option 2). Provide the information below for each person in your household.
AGE ____
GENDER _____
YEARS DRINKING SAN FRANCISCO TAP WATER _____
ETHNICITY
☐︎ African American
☐︎ Hispanic
☐︎ Caucasian
☐︎ Asian
☐︎ Other
PHYSICAL ACTIVITY LEVEL
☐︎ Low
☐︎ Moderate
☐︎ High
☐︎ Very High
HEALTH CONDITIONS
☐︎ Arthritis
☐︎ HIV/AIDS
☐︎ Hypothyroidism
☐︎ Renal Disease/Dialysis
☐︎ Pregnant/Nursing
☐︎ Idiopathic Environmental Intolerance (IEI)
☐︎ ADHD
☐︎ Cancer
☐︎ Irritable Bowel Syndrome
☐︎ Diabetes