Lead

Occupant Evaluation Form

 
1 Start 2 Complete

In an effort to improve the services provided by our program, we ask that you take a few minutes to complete this form. For each section listed, choose the number that most closely represents your experience: 

1 = Poor

2 = Needs improvement

3 = Average

4 = Good

5 = Excellent

Application & Enrollment

  • Communication with program staff and understanding of the program
  • Clarity and ease of submission of application form and related documents
  • Lead poisoning and program informational material
Application & Enrollment Comments:

Project Planning

  • Unit preparation information and site visit
  • Explanation of work to be completed
  • Scheduling of lead paint testing by consultant<
  • Lead testing results received
Project Planning Comments:

Relocation & Project Completion

  • Explanation of relocation requirements
  • Relocation assistance
  • Quality of relocation unit
  • Notification that your unit is ready for re-occupancy
  • Timely receipt of stipend (if this option was chosen)
  • Quality of work that was completed
Relocation & Project Completion Comments:

Media Release

The Burlington Lead Program uses occupant testimonies for outreach and marketing. If so inclined, please provide a few sentences about your experience with our program and sign below to consent to the public use of your statement.

Testimonial: