Maryland requires blood lead testing at the 12 and 24 month well-child visits, and families must show the results when a child enters child care, pre-kindergarten, kindergarten or first grade. The provider lists each test date, type and result on this certificate and signs it, or documents a religious objection after a lead risk questionnaire and counseling.
A health care provider records and certifies the tests by signature or stamp; a school health professional or designee may transcribe and certify results from another authenticated record. The parent signs only the refusal section, if used.
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Blood Lead Testing Certificate
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The certificate has a section for refusal based on bona fide religious beliefs and practices. The provider asks seven lead risk questions, initials that they counseled the parent if any answer is yes, and the parent signs the objection acknowledging the potential impact of not testing.
Maryland requires testing at the 12 and 24 month well-child visits, at 12 to 14 and 24 to 26 months of age, and both results should be listed. If the 12-month test was missed, a result after 24 months of age is sufficient.
The form says a copy in another language can be requested from the Maryland Department of Health Environmental Health Helpline. Providers can also hand families an ImmuNet printout of the results instead of completing the certificate.