Forms and Information for Health Care Providers and Researchers
Providers requesting a blood spot
If a specimen is needed for testing an infant or child who becomes ill, please complete and submit CDPH Form 4407, Consent for Release of Dried Blood Specimen from GDSP. The parent or legal guardian will need to sign the consent on Form 4407.
If you have questions regarding the California Biobank Program (CBP), email the California Biobank Program Coordinator at
CaliforniaBiobank@cdph.ca.govā.
Researchers requesting blood spots or serum samples
- All research projects are required to be approved by the State Committee for the Protection of Human Subjects (also called the state Institutional Review Board or IRB) to be sure the study is well-designed, ethical and protects patient confidentiality.
- The CBP makes specimens and data available to researchers for the following approved purposes:
- Identify risk factors for women's and children's diseases
- Develop and evaluate screening tests
- Develop and evaluate prevention strategies
- āDevelop and evaluate treatments.
To begin, researchers must submit a written request to CBP and include:
- Request for biospecimens and/or data
- Description of the research project ā
- Researcher's name, title, contact information, and institution
- Completed California Biobank Program
Initial Inquiry Form (PDF)ā.
More about our programs:
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The Newborn Screening Program tests all babies born in the State for multiple disorders. Available data includes patient demographic data, analyte values for the screening tests as performed, determination of screen positive or screen negative status, and resolution of positive results as true or false positive. Newborn screening data are available from 1982 onward.
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The Prenatal Screening Programā is offered to pregnant individuals and recommended before the 21st week of gestation. A maternal blood specimen is analyzed for multiple analytes then interpreted for risk for the screened disorders. Available data includes patient demographic data, analyte values for the screening tests as performed, determination of screen positive or screen negative status. Prenatal screening data are available from 1995 onward. Approximately 70% of pregnant individuals in California participate in prenatal screening, with samples stored from 10 diverse counties throughout the state.
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The California Birth Defects Monitoring Program (CBDMP) Registry actively reviews medical records to identify and describe major structural and chromosomal defects in a subset of California's population. Information on birth defects is collected for the first year of life from multiple sources including hospitals, laboratories, and genetic centers. CBDMP reports current rates and occurrence patterns concerning factors such as race, ethnicity, geographic region, type of defect, mother's age, single and multiple births. If you are a researcher and want to access the CBDMP registry datasets, please
contact CBDMP.ā