Practitioner Information

Forms

• American College of Medical Genetics ACT Sheets and Algorithms
• Child Find Referral Form
• NEW - Critical Congenital Heart Disease (CCHD) Screening Algorithm
• NEW - CCHD Reporting Form for Hospitals
• Newborn Screening Reorder Form
• Provider Update Form
• Provider Lab Result Request Form
• Refusal Form
• Newborn Screening Reference Manual for Providers
• Secure Remote Viewer (SRV) Instructions*
• Secure Remote Viewer (SRV) Registration Form*
• Hearing Result Reporting Form

*If you require technical support for the Secure Remote Viewer please call (334) 290-6702 or email the technical team at [email protected].

Alabama Bureau of Clinical Laboratories

The Alabama Bureau of Clinical Laboratories (BCL) performs all newborn screening tests in the state and should be contacted regarding specimen collection or filter forms. If more specimen kits are needed, please complete and submit the Reorder Form. You may refer to the Newborn Screening Blood Collection Guidelines for instructions regarding specimen collection.

In addition, please ensure that your contact information remains current with the state lab. You may update it at any time by completing the Newborn Screening Provider Update Form.

The BCL Newborn Screening Lab has provided the Secure Remote Viewer (SRV), a mechanism for providers to access their patient's newborn screening results. Providers must register for Secure Remote Viewer to access newborn screening results. Providers can register for SRV by completing the registration form and following the SRV instructions.

Dried Bloodspot Result Information for Providers

1. Within Normal Limits = screen was normal for the condition
   Action:  no additional follow-up is required
   Note:  False negative results may occur because the newborn screen is not diagnostic. A baby should be evaluated immediately should the baby develop symptoms.  Newborn screening should not replace clinical evaluation and assessment, nor should it take the place of confirmatory or diagnostic testing.
2. Borderline Result = screening result was between normal and out-of-range
   Action:  newborn screening follow-up staff will notify that a subsequent specimen is needed.  If the subsequent specimen remains borderline or becomes a positive result, follow-up staff will contact the infant's primary care provider and provide further recommendations as indicated.
3. Abnormal Result = screening result was not within normal limits
   Action:  If a newborn receives an abnormal result requiring clinical follow-up, newborn screening staff will contact the infant's primary care provider to discuss the abnormal result and fax the information needed to notify the parents and properly follow-up on the result.  Newborn screening staff may connect the provider to a medical specialist experienced in diagnosing and treating children with a disorder.
   Note:  Children may receive an abnormal result but later be found to be unaffected.  Although false positive results occur, it is crucial that all out-of-range results receive timely attention.
4. Presumptive Positive Result = result was not normal or out-of-range from a determined cut-off value set by a medical specialist. All "presumptive positive" results require diagnostic or confirmatory testing and evaluation.
   Action:  In the event of a presumptive positive result, newborn screening staff or a medical consultant will contact the newborn's primary care provider to discuss the result and fax the information needed to notify the parents and properly follow-up on the result.  Newborn screening staff can also connect the provider to medical specialists experienced in diagnosing and treating children with a condition.
   Note:  Children may receive a presumptive positive result but later be found to be unaffected. Although false positive results occur, it is crucial that all out-of-range results receive timely attention.
5. Unsatisfactory Result = screening results cannot be accurately interpreted because of a problem with collection or receipt by the State Health Laboratory. Most unsatisfactory results occur because of problems with collection, such as collecting blood on an expired specimen card, uneven saturation, inadequate blood, or contamination.
   Action:  Notification for the need of a subsequent specimen will be noted on the laboratory report if the initial specimen is unsatisfactory, or follow-up staff may send a letter to the physician of record requesting a satisfactory specimen if one is not received within three weeks from collection of the initial unsatisfactory specimen. It is the responsibility of the specimen submitter to monitor for specimen quality.

Reporting Changes for Newborn Screening Providers

Effective May 1, 2025, the Newborn Screening Laboratory Division will no longer mail abnormal and/or unsatisfactory laboratory reports to providers designated as "Primary Care Physician" on the collection form. Ordering physician/submitting facilities will still continue to receive paper copies of all results.

All newborn screening providers can view results via the Secure Remote Viewer (SRV). If you do not have access to the SRV, please follow the instructions. If you have questions, contact the Newborn Screening Division at (334) 290-3097 or [email protected].

American College of Medical Genetics - ACT Sheets and Algorithms

The American College of Medical Genetics has newborn screening condition resources for health care providers looking for information on genetic conditions (identified through newborn screening and beyond) to help inform clinical decision making. The ACT Sheets were developed by the American College of Medical Genetics and Genomics and the National Coordinating Center for the Regional Genetics Networks.

Given the rarity of many genetic conditions, ACT Sheets and algorithms are excellent refreshers on newborn screening conditions, diagnoses, and next steps for patients. The ACT Sheets include links to informational resources to allow the health professional to obtain additional information, if needed.

Alabama Early Intervention System (AEIS)

Early intervention is a coordinated, family-focused system of resource access, support, and services for eligible infants and toddlers, ages birth to 3 years who have developmental delays. AEIS is a statewide system that offers eligible families the opportunity to receive appropriate services, including assistive technology, audiology, family therapy, nursing, nutrition, occupational therapy, psychological services, service coordination, special instruction, social work, speech-language pathology, medical services, transportation, vision and health services, and physical therapy. AEIS helps families learn about resources, supports, and services that are available and how to care for a child who has special needs.

If a child in your care is in need of these services, complete the Child Find Referral Form and fax it to 334-293-7393 or call 1-800-543-3098 for more information.

Resources for Sickle Cell Disease and Trait

The Alabama Newborn Screening Program has partnered with Community Based Sickle Cell Organizations throughout the state who provide counseling services as well as other services to families of newborns identified with sickle cell disease or trait.

Please be sure to share this valuable resource with families in your practice who have a child with sickle cell disease or trait. You may also visit the Sickle Cell Association of America website for additional resources.

Obstetric Provider Information

The American College of Obstetricians and Gynecologists published an article, Newborn Screening and the Obstetrician, which recommends as a best practice to educate parents about the importance of newborn screening for heritable and congenital disorders prior to delivery. According to the authors of this article, obstetric providers should, at some time during pregnancy, review the basic process of newborn screening with parents to prepare them for newborn screening in the neonatal period. In addition, it is encouraged that verbal discussion and distribution of written materials be incorporated.

Obstetric providers play a significant role in educating expectant parents about newborn screening and the life-saving impact that it can have on infants affected by screened disorders. Below are some resources available for obstetric, as well as pediatric, providers.

Resources

• American Academy of Pediatrics - Introduction to Newborn Screening Fact Sheets
• American Academy of Pediatrics - Newborn Screening Expands: Recommendations for Medical Homes
• American Academy of Pediatrics - Newborn Screening Podcast Episode
• Baby's First Test: Critical Congenital Heart Disease
• CDC Grand Rounds: Newborn Screening and Improved Outcomes
• Children's National Medical Center Congenital Heart Disease Screening Program Overview
• Cystic Fibrosis Infographic for Healthcare Providers
• Delivering You the Facts: What Parents Should Know About Newborn Screening
• Guide for Prenatal Educators
• Hospital Newborn Screening Continuity of Operations Planning Guide
• HCU (Homocystinuria) Network America
• Letters to Health Care Providers
• Prenatal and Newborn Screening Pamphlet
• Recommended Uniform Screening Panel Core Conditions (RUSP)
• Refusal Form for Newborn Screening
• Reporting Form for Outpatient Hearing Screen/ Diagnostic Audiological Evaluation
• Severe Combined Immunodeficiency: Newborn Screening Could Detect Bubble Boy Illness Early
• Sickle Cell Disease Association of America, Inc.
• Sickle Cell Brochure