Lead Paint
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Street Address:
Apartment number:
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City:
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Zip code:
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Your numeric answer for question does not fall within the range of -2147483648 to 2147483647.
Number of people in household:
Please answer question Any children 6 yrs or under before continuing.
Any children 6 yrs or under?
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Date completed tool:
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Did you have a home visit by program Staff?
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Email address:
Do you want to be notified of updates and new services by the program?
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Your answer to question must be a whole number.
Your numeric answer for question does not fall within the range of 0 to 25.
Your Score: How many boxes were checked off on your home tool? 0-25 should be optimal.
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