The City of Memphis’ LEAD-SAFE program provides income-eligible residents with FREE lead-hazard reduction services. Click here to download the screening process application or fill out the submission below to see if you qualify for a lead-based paint home inspection at NO COST to you.

 

APPLICANT INFORMATION
First & Last Name
Address
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Country
Phone

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Email
Who Referred You?
ENROLLED UNIT INFORMATION
Unit Address
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Country
What year was the structure built?
What type property?
 Rental 
 Owner Occupied  
 Single-Family 
 Duplex 
 Multi-Family 
How Many Units?
Are there any children age 5 and under who reside or visit for more than 60 hours within one year?
 Yes 
 No 
Have you ever participated in our program before?
 Yes 
 No 
If so, when?
Are your city and county property taxes current?
 Yes 
 No 
Have you made any improvements on this property in the last 3 years?
 Yes 
 No 
Do you have property Insurance?
 Yes 
 No 
Are you able to obtain income information from all residents over 18 years old?
 Yes 
 No 
Message or Comments
DISCLAIMER & ELECTRONIC SIGNATURE
I certify that my answers are true and complete to the best of my knowledge. If this application leads to assistance, I understand that false or misleading information in my application or interview may result in denial of assistance. Please type name in field.
Date
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