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Healthy Homes Program Interest Form

  1. The Healthy Homes Program takes a comprehensive approach by focusing on housing-related hazards in a coordinated fashion, rather than addressing a single hazard at a time including mold, water intrusion, lead paint, allergens, asthma, carbon monoxide, home safety, pesticides, and radon (a dangerous gas found mainly in basements). Fill out this interest form and we will be in touch!

  2. Do you rent or own your home?*
  3. What year was the home built? *
  4. Do children under the age of 6 live in the home or regularly visit?*
  5. Which of the following do you feel applies to your home? Check all that apply.*
  6. Leave This Blank:

  7. This field is not part of the form submission.