Refusal of Newborn Testing/Screening

Parental Right to Refuse

Refusal Text on the back side of Newborn Screening card

According to state law (RCW 70.83.020), a newborn screening specimen should not be obtained for any infant whose parents or guardian object due to religious tenets and practices.

To document this decision, it is the responsibility of the birth facility (or birth attendant if the infant was born at home) to obtain the signature of the infant's parent/guardian on the reverse side of newborn screening card in the space provided.

The signed card must be sent to the Newborn Screening Laboratory.

Please see the Health Care Provider Manual (PDF) for additional details.

Refusal text in different languages

The refusal text in the PDF documents below is for providers to use with parents/guardians who decide to refuse newborn testing per RCW 70.83.020, so that the parent/guardian understands what they are signing on the back of the Newborn Screening card.

  • Do not obtain signatures on or send the reference documents below.
  • The only accepted documentation for the decision to refuse testing is the parent/guardian's signature on the reverse side of the Newborn Screening card.

Please keep a laminated copy of these PDF texts in your facility or practice for your clients.

English Spanish Russian
Vietnamese Ukrainian Somali
Korean Tagalog Arabic

Refusal text in English- for reference only

Newborn screening to detect serious congenital disorders is mandatory in the state of Washington. Parents or guardians may refuse testing only on the basis of religious practices or tenets as provided by RCW 70.83.020.

I am the parent or guardian of the infant named below. I have been counseled on the importance of Newborn Screening tests and I have received literature on Newborn Screening. My questions have been answered to my satisfaction.

I understand that:

  • The disorders detectable by newborn screening may cause life threatening conditions, serious medical conditions, physical or mental disabilities, or even death.

  • Testing within 48 hours after birth is important because babies with these disorders usually look normal and these conditions may cause severe permanent health problems before any symptoms appear.

  • Choosing not to have my newborn screened may result in delayed treatment if s/he has a disease or condition that can be detected by newborn screening.

I have been advised of the benefits of newborn screening and understand the potential risks to my child by not participating. Nevertheless, I refuse to have blood taken from my child for the purpose of newborn screening on the grounds that such tests conflict with my religious tenets and/or practices.

I release and hold harmless the Washington State Department of Health, the facility of birth, and the person responsible for collecting the newborn screening sample, for any injury, illness, or medical condition to my child, or even the death of my child, any of which may be caused by a disorder that is screened for under the State's newborn screening comprehensive testing panel, which screening I am hereby refusing for my child.

Due to my religious beliefs, I decline to have newborn screening tests performed on my child and I accept full responsibility for the consequences of my decision.