Lead Forms

NOTICE

Please send separate payments for lead and asbestos fees.

MDH cannot process payments that combine fees for lead and asbestos.

MDH will return applications submitted with payments that combine fees for asbestos and lead.

Application forms

• Individual Lead License Application (PDF)
  Use this form to apply for a worker, supervisor, inspector, risk assessor, or project designer license. Use this application for initial, renewal, and duplicate licenses.
• Lead Firm Certification Application (PDF)
  Use this form to apply for a Lead Firm Certification.
  Note: This form does not meet the regulatory requirements for the EPA's Renovation, Repair and Painting (RRP) Rule.
• Lead Training Course Permit Application (PDF)
  Use this form to apply for a training course permit at least 60 calendar days in advance of holding the course.

Notification forms

• Lead Hazard Reduction Notification (PDF)
  Use this form to notify MDH of lead hazard reduction work at least five calendar days before the project begins. Use this form for initial notifications, amendments, and cancellations.
• Lead Training Course Notification (PDF)
  Use this form to meet the requirement for training course providers to notify MDH five calendar days before the start of a training course.

Templates

• Lead Hazard Reduction Report Template (PDF)
  Use this template for lead hazard reduction reports. Upon completion of regulated lead work, certified lead firms must complete and maintain this report for three years.
• Lead Training Course Daily Sign-in Log (PDF)
  Training course providers must submit a list of trainees to MDH within five calendar days of course completion.