Useful forms and Tools For Local Health Department Staff
Childhood Lead-based Paint Program Tools / Forms
- Fingerstick Training
- Publications
- Supply Order Form (All Providers - both Medicaid and non-Medicaid Eligible)
- Lead Screening Requirements & Medical Management Recommendations
- Nurse's Home Visit Form (to be used during the Initial Home Visit of the EBLL child)
- Case Management
- Rule 410 Indiana Administrative Code 29 (Case Management Rule)
- Rule 410 Indiana Administrative Code 32 (Lead-based Paint Rule)
- ISDH Laboratory Environmental Lead in Paint Chip Sample Submission form
- ISDH Laboratory Environmental Lead in Dust Wipe Sample Submission form
- ISDH Laboratory Environmental Lead in Water Sample Submission form
- ISDH Laboratory Environmental Lead in Soil Sample Submission form
- Map of Regional Case Coordinators for lead poisoned children
Radon Program Tools / Forms
- List of Indiana-licensed Radon Testing Professionals
- List of Indiana-licensed Radon Mitigation System Installers
- Rule 410 Indiana Administrative Code 5.1 (Radon Rule)
- Citizen's Guide to Radon pamphlet
- Consumer's Guide to Radon Reduction pamphlet
- Home Buyers and Sellers Guide to Radon pamphlet
- Indiana's Radon Fact Sheet
Online Services
Stay Connected
You are leaving the IN.gov website. By clicking OK, you will be taken to a website that is not affiliated with the State of Indiana and may have different privacy and security policies. The State of Indiana is not responsible for, and does not endorse, guarantee, or monitor content, availability, viewpoints, products, or services that are offered or expressed on this non IN.gov portal website.
