Newborn Screening

For Parents

• DPH 1804 - Newborn Screening Dried Blood Spot Screening Refusal Form (pdf)
  • Spanish
  • Russian
  • Ukrainian
  • Portuguese
  • French
• DPH 1878- Authorization to Release Dried Blood Spot Newborn Screening Results (pdf)

For Providers

• DPH 4474 - Inborn Errors of Metabolism and Hemoglobinopathies Reporting Form (pdf)
• DPH 3268 - NBS Specimen Gate eReport User Agreement Form
• DPH 4493 - Correction Request for Submitted NBS Specimen (pdf)
• Cystic Fibrosis Testing Algorithm Flow Chart (pdf)
• Training Video for Newborn Screening eReport Web Portal
• Training Video for Newborn Screening Bloodspot Specimens (YouTube)
• Newborn Screening Lunch & Learn: Krabbe Provider Training - June 21, 2023 (YouTube)

Lab Request Form for Serology, STI, and Analytical Chemistry Testing

• DPH 1332 - Laboratory Test Request Form (pdf)

OpenELIS

• DPH 3952 - OpenELIS Web User and Confidentiality Agreement
• DPH 1335 - OpenELIS (COVID testing) Laboratory Test Request Form (pdf)