Required fields are marked with asterisks (*)

Newborn Screening Results Request Form

For the privacy and protection of this child, this form must be completed by the child's parent, guardian, or health care provider. Results will be released to the health care provider you list below. If there is a clinical reason for which you would like your request to be expedited, please review our special results request process and contact Newborn Screening Ontario directly.

Results requests for documentation purposes will be fulfilled within 14 days. We continue to recommend OLIS as the most efficient way to access results: https://ehealthontario.on.ca/en/standards/ontario-laboratories-information-system-standard

Who is completing this form?

I am this child's parent and legal guardian

I am this child's legal guardian (please download the request form above and mail it to NSO with the completed Proof of Guardianship form)

I am this child's health care provider

Your name:

Your phone number

Your email

If you are a health care provider, please indicate the reason for your request

Medical record documentation (e.g. confirmation that the infant was screened)

The infant is not well and I am concerned they may be symptomatic of a disease targeted by newborn screening

The infant is at risk for a disease targeted by newborn screening (e.g. family history of the disease)