Lead-Safe Wisconsin - Forms and Publications

The lead-related forms and publications hosted on this website are organized into three audiences: Contractors/Companies, Public Health, and Landlords/Tenants. Please choose one of the the following tabs for forms and publications related to that category.

Contractors /
Companies

The lead-related forms and publications listed below provide information to the inspector, investigator, contractor, risk assessor, and hazard investigator. These forms can be used to apply for certification, or when preparing to perform work on a property with lead-based paint. View an alphabetical list of forms and publications.

Forms

Lead (Pb) Certification Application - Company (F-00171, PDF, 604 KB) - Complete this form to certify as a lead company. This form can also be used to renew certification.

Lead-Safe Renovator Application (F-44003, PDF, 620 KB) - Complete this form to certify as a lead-safe renovator. This form can also be used to renew certification.

Initial Application - Individual Lead Disciplines (F-02031, PDF, 656 KB) - Use this form to apply for first-time certification as an abatement supervisor, abatement worker, sampling technician, hazard investigator, risk assessor, inspector or project designer. 

Renewal Application - Individual Lead Disciplines (F-01989, PDF,  644KB) - Use this form to renew certification as an abatement supervisor, abatement worker, sampling technician, hazard investigator, risk assessor, inspector or project designer. 

Lead-Based Paint Investigation Summary Report (F-44013, PDF, 15 KB) - Lead investigation professionals must use this form to report lead investigation activities conducted within 30 days of the end of each quarter.

Notification of Lead-Based Paint Activity (F-44012, PDF, 26 KB) - Abatement supervisors must complete and submit this form to DHS two days before lead abatement work takes place.

Occupant Protection Plan (F-00201, Word, 41 KB) | En Español (F-00201, Word, 47 KB) - Abatement supervisors must complete this form and provide it to occupants before lead abatement work takes place.

Publications

HUD Technical Guidelines for the Evaluation and Control of Lead-Based Paint Hazards in Housing (link is external) - These guidelines provide detailed, technical information on how to identify and control lead-based paint hazards.

Lead Paint Safety: A Field Guide for Painting, Home Maintenance, and Renovation Work (link is external) (PDF, 1.3 MB)| En Español (link is external) (PDF, 1.9 MB) - A step-by-step manual that illustrates the safety precautions to take when painting, doing maintenance, or renovating in homes built before 1978.

The Lead-Safe Certified Guide to Renovate Right (link is external) (PDF, 3.3 MB) | En Español (link is external) (PDF, 3.2 MB) - This handbook for contractors, property managers, and maintenance personnel describes the requirements that apply when more than 6 square interior feet or 20 square exterior feet of surface with lead-based paint is disturbed.

 

Public Health

Bookmarks/Toolkits and federal resources for outreach and education are located on this webpage.

Forms

Some links for forms are to web pages where the forms are available as either a Word-fillable document or a PDF.

Blood Lead Lab Reporting F-00017 (Word, 22 KB)

Nursing Case Management Report/Case Management of Children with Elevated Blood Lead Levels F-44771A

Medicaid Targeted Case Management Face Sheet - Childhood Lead Poisoning F-44771AA (Word,  53 KB)

Nursing Case Closure Report/Case Management of Children with Elevated Blood Lead Levels F-44771B

Property Investigation Report/Case Management of Children with Elevated Blood Lead Levels F-4471C

Property Investigation Closure Report/Case Management of Children with Elevated Blood Lead Levels F-44771D

Publications

Report on Childhood Lead Poisoning in Wisconsin - 2014 P-01202 (PDF, 8.0 MB)

Childproof Your Home Improvements (PDF, 2.7 MB)

Feeding Your Child -13. Eating Right: Preventing Childhood Lead Poisoning - A two-sided card in English P-44968 (PDF, 295 KB) Spanish P-44968S (PDF, 641 KB).

Lead and Pregnancy - Paper copies of this pamphlet in English P-49299 and Spanish P-49299S can be ordered online using the forms on this web page.

Lead Poisoning Prevention: Tools and Resources for Community Awareness P-00554-2016 (PDF, 558 KB)

Lead Safety Field Guide - Paper copies of this pamphlet in English P-45035 and Spanish P-45035S can be ordered online using the forms on this web page.

Legacy of Lead: Report on Childhood Lead Poisoning in Wisconsin, 2008 - Full report P-45109 (PDF, 4.1 MB) and summary P-45109A (PDF, 696 KB)

Look Out for Lead - Parents - A tri-fold pamphlet in English P-44535A (PDF, 330 KB)  Spanish P-44535AS (PDF, 94 KB).

Look Out for Lead - Property Owners P-44535B (PDF, 330 KB)

Prevent Lead Poisoning: 5 Reasons to Hire a Lead-Safe Contractor P-00296 (PDF, 109 KB)

Protect Your Family from Lead in Your Home in English (PDF, 1.6 MB).  Paper copies in Spanish of this pamphlet can be ordered online using the forms on this web page.

Renovate Right: Important Lead Hazard Information for Families, Child Care Providers and Schools P-90000 - Paper copies of this pamphlet can be ordered online using the forms on this web page.

Ripple Effects of Childhood Lead Poisoning (link is external) - interactive information-graphic from Lead-Safe Illinois website.

WCLPPP Standard for for Home and Childcare Site Intervention to Address Lead Hazards toolkit P-00716 (PDF, 727 KB)

Wisconsin Childhood Lead Poisoning Prevention and Control Handbook for Local Public Health Departments P-00660 (PDF, 8.0 MB) or go to the Local Public Health Interventions page for individual chapters of the handbook.

Your Child's Blood Lead Test Results (link is external) (PDF, 861 KB) - National Center for Healthy Homes, a fact sheet and checklist for parents

Blood Lead Levels in Children (link is external) (PDF, 292 KB) - From the Centers for Disease Control and Prevention, a fact sheet with guidance for health care providers when talking with parents about their child's blood lead level.

Landlord/Tenant

Owners, landlords, agents, and managers of rental property play an important role in protecting the health of their tenants and tenants' children. Buildings built before 1978 are much more likely to have lead-based paint. Federal law requires that landlords provide certain important information about lead paint before a prospective renter is obligated under a rental lease.

Brief Overview

Rental Property Owners: Look Out for Lead P-44535B (PDF, 334 KB). A tri-fold pamphlet for rental property owners who own property built before 1978 that may contain lead hazards and may be occupied by families with young children. Includes information on what can be done to correct lead hazards and about the law to notify tenants about lead hazards and how to prevent exposure to lead.

Landlords must provide the following to prospective tenants of buildings built before 1978:
  • Protect Your Family From Lead in Your Home, in English P-49370 (PDF, 6 MB) and other languages. Rental property owners of pre-1978 housing are required to give this pamphlet to tenants when entering into or renewing a rental agreement (link is external).
  • Any known information concerning lead-based paint or lead-based paint hazards pertaining to the building. For multi-unit buildings, this requirement includes records and reports concerning common areas and other units when such information was obtained as a result of a building-wide evaluation.
  • Disclosure of Information on Lead-Based Paint and/or Lead-Based Hazards: A lead disclosure attachment in English (PDF, 162 KB) or Spanish (PDF, 172 KB) to the lease, or language inserted in the lease, that includes a "Lead Warning Statement" and confirms that the landlord has complied with all notification requirements.
Landlords must maintain and renovate their property in a lead-safe manner:
  • Lead Paint Safety: A Field Guide for Painting, Home Maintenance, and Renovation Work - In  (link is exterEnglish (PDF,  1.3 MB); Spanish (PDF,  1.9 MB). This step-by-step manual illustrates the safety precautions to take when painting, doing maintenance, or renovating in homes built before 1978.
  • The Lead-Safe Certified Guide to Renovate Right. Rental property owners must provide this pamphlet (in  (link is extEnglish (PDF, 9.6 MB); (link is externaSpanish (PDF,  4.6 MB)) to their tenants before performing any renovation, remodeling, or repainting of their property. The pamphlet provides important information about what lead-safe work practices should look like and that the work must be completed by a lead-safe certified renovator.
Last Revised: June 16, 2017