Apply for Lead Safe

If your institution is interested in participating in the Lead Safe program, please fill-out the following application to the Chicago Department of Public Health. All applications must have a clinician and technical contact identified before application, meet the eligibility requirements and agree to the terms of service. Clinicians must be licensed doctors who will help their health network use Lead Safe as part of the hospital's daily operations. The technical contact should be able to work to connect electronic medical records to the Lead Safe API. If you have any questions, please contact HealthyHomes@cityofchicago.org.

Please select from one of the eligible health networks

Please provide information on the lead clinical contact

person
assignment
local_hospital
fingerprint
place
phone
email

Please provide contact information for the technical advisor

person
assignment
place
phone
email

Eligibility Criteria

I have read the eligibility criteria and certify that this institution meets the minimum standards.

Terms of Service

I accept the Terms of Service