Childhood Lead Risk Questionnaire

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All children 6 years of age or younger must be evaluated for lead exposure.
All children must be assessed for risk of lead exposure and tested if necessary for enrollment into daycare, preschool, and kindergarten.

Complete the Childhood Lead Risk Questionnaire during a well-child or health care visit for children ages 12 and 24 months of age (at minimum) and once a year at annual well-child-visits at ages 3, 4, 5, and 6 years.

  • If responses to all the questions are "NO," re-evaluate at the next age referenced above or more often if deemed necessary.
  • If any response is "'YES" or "DON'T KNOW," a blood lead test must be obtained.
  • If there are any "YES" or "DON" T KNOW" answers and
  • Previous blood lead testing was done at 12 and 24 months of age with a result of 4.9 ug/dL or less OR if not performed at 12 and 24 months, a blood lead test was performed at 3, 4, 5, or 6 years of age with a result of 4.9 ug/dL or less, and
  • There has been no change in address of the child's home/residential building, child care facility, school, or other frequently visited facilities and
  • Risks of exposure to lead have not changed, further blood lead tests are not necessary,

All Medicaid-eligible children and children enrolled in HFS medical programs shall have a blood lead test at 12 and at 24 months of age. If a Medicaid-eligible child or HFS medical program enrolled child between 36 months and 72 months of age has not been previously tested, a blood lead test shall be performed.

ALL blood lead test results MUST be submitted to the Illinois Lead Program.
Fax: 217-557-1188 Phone: 866-909-3572

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