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This document serves as a directive for parents or guardians to request the destruction of newborn screening blood samples and/or test results received by the Minnesota Department of Health between

How to fill out directive to destroy newborn

How to fill out Directive to Destroy Newborn Screening Blood Samples and/or Test Results

1. Obtain a copy of the Directive to Destroy Newborn Screening Blood Samples and/or Test Results form.
2. Fill in the required personal details, including the child's full name, date of birth, and identification number.
3. Indicate the specific samples or test results you wish to be destroyed.
4. Provide the reason for the destruction request, ensuring it complies with relevant regulations.
5. Sign and date the form to authenticate your request.
6. Submit the completed directive to the appropriate healthcare authority or laboratory.

Who needs Directive to Destroy Newborn Screening Blood Samples and/or Test Results?

1. Parents or guardians of newborns whose screening samples or test results are no longer needed.
2. Healthcare providers requiring clearance of old or redundant newborn screening data.
3. Organizations managing newborn screening programs that need to comply with data retention policies.

People Also Ask about

What is the card test for newborns?

During the newborn blood spot test, a healthcare professional will your baby's heel using a device that has a tiny needle and collect a few drops of blood on a special card. The card is then sent away to be tested. The test is very quick and there are no known risks to your baby.

Why do parents refuse newborn screening?

Mostly these parents are scared into thinking that something bad will be done with their baby's blood. Something beyond testing it for up to 50 or more life-threatening diseases that are often treatable when detected early, which is why newborn screening tests are a thing.

What is included in newborn blood screening?

Within 48 hours of a child's birth, a sample of blood is obtained from a “heel stick,” and the blood is analyzed for up to 50 diseases, including phenylketonuria (PKU), sickle cell disease, and hypothyroidism. The sample, called a “blood spot,” is tested at a state public health or other participating laboratory.

What is a newborn blood screening card?

Early treatment can improve their health and prevent severe disability or even death. When the baby is five days old, a health professional will their heel and collect four drops of blood on a special card. The blood spot test screens for the following rare conditions: sickle cell disease (SCD)

What is a newborn screening sample?

How Is Newborn Screening Done? A small blood sample taken by pricking the baby's heel is tested. This happens before the baby leaves the hospital, usually at 1 or 2 days of age. Talk to your doctor about newborn screening if your baby was not born in a hospital.

What does a newborn bloodspot screening test for?

Newborn bloodspot screening tests for a number of conditions, including: Phenylketonuria – the liver does not produce enough of a particular enzyme, which can cause intellectual disability if untreated. Congenital Hypothyroidism – the baby does not produce enough thyroid hormone.

What is an infant screening card?

Newborn screening usually starts with a blood test, followed by a hearing test and possibly other tests. First, hospital staff fill out a newborn screening card with the infant's vital information — name, sex, weight, and date and time of birth — and the date and time of the blood collection.

What are the results of a newborn blood screening test?

There are four possible results in newborn blood spot screening: Within Normal Limits/Negative, Trait, Borderline, and Positive/Abnormal. A Within Normal Limits or Negative result means that the screen was normal for the disorder and no additional follow-up is required.

For pdfFiller’s FAQs

What is Directive to Destroy Newborn Screening Blood Samples and/or Test Results?

The Directive to Destroy Newborn Screening Blood Samples and/or Test Results is a formal request or order to eliminate specific samples or their associated test outcomes that are no longer needed or are required to be destroyed in accordance with regulations or parental consent.

Who is required to file Directive to Destroy Newborn Screening Blood Samples and/or Test Results?

Healthcare providers or institutions that have collected newborn screening blood samples and generated test results are typically required to file the Directive to Destroy these materials, especially when there is a request from parents or guardians, or when regulatory requirements mandate disposal.

How to fill out Directive to Destroy Newborn Screening Blood Samples and/or Test Results?

To fill out the Directive to Destroy Newborn Screening Blood Samples and/or Test Results, the filer must provide details such as the patient's identification information, the details of the samples and/or test results to be destroyed, the reason for destruction, and any relevant consents or authorizations from the parents or guardians.

What is the purpose of Directive to Destroy Newborn Screening Blood Samples and/or Test Results?

The purpose of the Directive to Destroy Newborn Screening Blood Samples and/or Test Results is to ensure compliance with privacy laws, protect patient confidentiality, and eradicate samples or results that are no longer necessary or have been requested to be disposed of by parents or guardians.

What information must be reported on Directive to Destroy Newborn Screening Blood Samples and/or Test Results?

The Directive must report information including the newborn's name, date of birth, medical record number, details of the samples or test results involved, reasons for destruction, and signatures from the responsible parties as required for legal compliance.