Forms

Download Newborn Screening Forms

Newborn Screening Forms

Download and print Newborn Screening form PDFs

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Consent for Retention - English

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Consent for Retention - Spanish

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Request to Destroy Newborn Screening Blood Spot Card

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Religious Objection Form

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Newborn Screening Brochure - English

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Newborn Screening Brochure - Spanish

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Multi-Agency State Office Building
4431 South 2700 West
Taylorsville, Utah
84129
Phone: (801) 584-8256
Email: [email protected]
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    • Consent for Retention – English
    • Consent for Retention – Spanish
    • Religious Objection Form
    • Blood Spot Sample Destruction Request
    • Newborn Screening Brochure – English
    • Newborn Screening Brochure – Spanish

Resources

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Hotlines

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1-800-371-7897

Child Abuse/Neglect
1-855-323-DCFS(3237)

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1-801-587-3000

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1-800-273-TALK(8255)

Sexual Violence Crisis Line
1-888-421-1100

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1-800-897-LINK(5465)

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