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Lead and Healthy Homes Division
Home Visit Form
RETURN WITHIN 10 BUSINESS DAYS (Please Print)Interviewer:Date of Home Visit:(Entrevistador)(Tech DE la visit domiciliary)Agency:
(Agency)Person Interviewed:Relationship:(Persona
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How to fill out lead and healthy homes

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01
Gather all necessary information such as full name, contact details, and address of the individual or family.
02
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Who needs lead and healthy homes?
01
Individuals or families living in homes or properties that may have lead-based paint hazards.
02
Individuals or families with young children or pregnant women who are at higher risk of lead poisoning.
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Low-income individuals or families who may require financial assistance for lead and healthy homes remediation.
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Homeowners or tenants who are concerned about the safety and health of their living environment.
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What is lead and healthy homes?
Lead and healthy homes refers to regulations and programs aimed at protecting families from lead exposure and ensuring that their homes are safe and healthy.
Who is required to file lead and healthy homes?
Property owners, landlords, or property managers are typically required to file lead and healthy homes forms.
How to fill out lead and healthy homes?
To fill out lead and healthy homes forms, you will need to provide information about the property, any lead hazards present, and steps taken to address them.
What is the purpose of lead and healthy homes?
The purpose of lead and healthy homes is to protect residents, especially children, from the harmful effects of lead exposure and ensure that homes are safe and healthy to live in.
What information must be reported on lead and healthy homes?
Information such as the presence of lead hazards, steps taken to address them, and any testing or inspection results must be reported on lead and healthy homes forms.
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