Newborn Screening Testing - Supplies Order Form

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The Laboratory Services Division reserves the right to limit supply shipments based on
customer usage and supply stock.
Please limit ordering to several months of supplies only and do not order a year's stock.

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Shipping Contact Information

* First Name

* Last Name

* Agency/Facility Name

* Street Address (P.O. boxes not permitted)

Suite or Floor Number

* City

* State

(Other state name)

* Zip Code

* Phone Number

E-mail Address (for follow-up regarding your order)

Confirm E-mail & receive order receipt

Practitioners who use the Colorado Department of Public Health and Environment
Newborn Screening Laboratory services are not charged for supplies.

Orders are limited to three months supply of materials.

(The Laboratory Services Division reserves the right to change
the requested amounts on the order, due to availability of supplies.)

Supply Item Quantity Description

Double NBS Form
(1st and 2nd screens)

Supplemental NBS Form (2nd screen)

This form is for doctors' offices or clinics in Colorado or Wyoming
or
non-Colorado/Wyoming birthing facilities.

Pre-addressed Newborn Screening envelopes

Newborn Screening brochures for parents (English version)
*Quantities are limited. Please print the brochure from the link
below if your facility has this capability.

Newborn Screening brochures for parents (Spanish version)
*Quantities are limited. Please print the brochure from the link
below if your facility has this capability.

Brochures mailed from the CDPHE Laboratory
are temporarily being supplied in black and white print.

Click here to view and print the Newborn Screening brochure for parents. (English version)

Click here to view and print the Newborn Screening brochure for parents. (Spanish version)

Request a FedEx Tracking Number by checking below
(Valid E-mail address is required)

E-MAIL a FEDEX TRACKING NUMBER

Contact the Newborn Screening Laboratory

For any additional requests of the Newborn Screening laboratory,
please contact the lab via e-mail at: cdphe.lab@cdphe.state.co.us
or by phone at: 303-692-3670

* Indicates Response Required