Schedule a Test

To schedule a test call our direct number (425) 277-2888 or fill out the information in the form below.

At Backflows Northwest we understand that an annual test does not need to be a complicated event. Once you send us your information we will contact you to confirm the time, price and any special circumstances. Provided no additional repairs are needed, your test results will be sent to the appropriate water purveyor (company/department) and you will receive your invoice. It's that easy!

Schedule a Test Form
Contact Name:		* required
Company Name:
Email:
Phone:
Alternate Phone:
Fax:
Test Address:
City, State, Zip:
Billing Address:
	(If different from above)
Billing City, State, Zip:
Backflow Assembly Information:
Water Purveyor (Company):
Number of Assemblies:
Backflow assembly location:	Indoors Outside
Are there any factors that would affect access?:	Yes No
	Confined Space, Vault, Plants, Fence, Locks, Renter Notification, etc.
If Yes, please describe here:
	In the case of an indoor location please provide preferred Date/Day/Times in box below.
Preferred Appointment Times: