Lead Based Paint Hazard Reduction Program Referral

Questions? Please call 832-393-5141.

Name

Email

Phone

Address

City/Town

State/Province

ZIP/Postal Code

Do you prefer to be contacted in English or Spanish?

Contact me in English

Contact me in Spanish

Referred by

Was the home built before 1978?

Yes

No

Does the home have any chipping, pealing, or cracking paint?

Yes

No

Does a child under six years old visit or live in the home?

Yes

No

Does a pregnant person live in the home?

Yes

No

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Page last reviewed: August 7, 2023