NBS Order Form
How to Get NBS Results
Complete the Consent for Release of Information form in its entirety and submit it to the Newborn Screening Program by email (NBS.Results@cdph.ca.gov), fax (510-412-1559), or mail (Attn: NBS Results, Genetic Disease Screening Program, 850 Marina Bay Parkway, F175 MS8200, Richmond, CA 94804).
Per HIPAA regulations, a parent/guardian signature is required unless the request is being submitted by the physician of record. If the family is unavailable to sign the consent form but has already signed a ‘Consent to Treat’ or ‘Consent for Release of Information’, a copy of that release may be accepted, provided it includes the minimum information needed. If the NBS Test Request Form is available, this may be sent by the physician on record in lieu of the Consent for Release of Information form so long as the request specifies who the records should be released to.
- Consent for Disclosure and/or Release of Confidential Information from GDSP
- CDPH 4408 SP (PDF)