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State of CaliforniaHealth and Human Services Agency California Department of Public Health PARENT REQUEST TO HAVE NEWBORN BLOOD SPECIMEN CARD DESTROYED If mother is unable to sign, please enclose

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How to fill out newborn blood specimen card

01

Step 1: Gather all the necessary materials including the newborn blood specimen card, a lancet or heel stick device, alcohol swabs, and a pen.

02

Step 2: Ensure that the newborn is in a calm and comfortable position.

03

Step 3: Clean the baby's heel with an alcohol swab and allow it to dry.

04

Step 4: Position the lancet or heel stick device against the baby's heel and quickly puncture the skin to create a small blood drop.

05

Step 5: Gently squeeze the baby's heel to create a steady flow of blood.

06

Step 6: Apply the blood drop onto the designated spots on the newborn blood specimen card.

07

Step 7: Allow the blood to dry completely before closing the card.

08

Step 8: Once the card is dry, label it with the baby's name, date of birth, and other required information.

09

Step 9: Store the completed newborn blood specimen card in a secure and appropriate location for transportation to the designated laboratory.

Who needs newborn blood specimen card?

01

The newborn blood specimen card is typically required for all newborn babies.

02

It is used as a screening tool to detect various metabolic, endocrine, and genetic disorders early on.

03

The card is usually filled out by healthcare professionals such as doctors, nurses, or midwives.

04

Parents may also be involved in filling out certain sections of the card, including the personal information of the baby.

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What is newborn blood specimen card?

Newborn blood specimen card is a form used to collect a blood sample from a newborn for testing purposes.

Who is required to file newborn blood specimen card?

Healthcare providers or hospital staff responsible for collecting the newborn blood sample are required to file the specimen card.

How to fill out newborn blood specimen card?

The newborn blood specimen card must be filled out by providing accurate information such as the baby's name, date of birth, and other relevant details.

What is the purpose of newborn blood specimen card?

The purpose of the newborn blood specimen card is to screen newborns for certain disorders or diseases that may not be apparent at birth.

What information must be reported on newborn blood specimen card?

The information reported on the newborn blood specimen card includes the baby's name, date of birth, time of sample collection, and other identifying details.

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