Blood Spot Screening Forms & Requests
Newborn Screening Brochure Order Form
This brochure is available for hospitals, clinics, and midwives to provide to their patients.
Newborn Screening Return of Blood Spot Card Request
This form is used for patients who would like their child's blood spot card returned to them after processing.
Request Access to View Newborn Blood Spot Screening Results
This form is for medical providers to request access to obtain test results.
Request Newborn Blood Spot Cards
To view a copy of the ND blood spot card, click here.
Hearing Screening & Diagnostic Reporting Forms
ND EHDI Information System Reporting
Access the online case management system OZ eSP to find results for patients.
To request an OZ eSP user account, contact Christine at 701-858-3580 or christine.brigden@ndus.edu or
Jerusha at jerusha.olthoff@ndus.edu
For any password or access issues contact the helpdesk at 866-427-5768.
CCHD Reporting & Forms
CCHD Forms
To ensure data accuracy, the pediatric cardiologist or a designated member of the cardiology team, should complete the reporting form within three months of the baby's first cardiology visit. A nurse from the Newborn Screening Program will contact the parent/guardian of a child with CCHD on a routine basis after their child is diagnosed to ensure the family has the needed resources and services, they need to keep their child healthy.