• Reporting Blood Lead Results Electronically Sign-up Form

    Please complete this form below to sign-up to report blood lead reports electronically. Once you submit your information a person from the Texas Department of State Health Services will contact you and provide instructions on how to upload the blood lead reports to a secure ftp server.

    Clinic Name:  
    Organization:  
    Tax ID:  
    Healthcare Provider Name:  
    Contact Person:  
    Email:  
    Supervisor Email:  
    Phone:  
    Supervisor Phone:  
    Fax:  
    Street Address:  
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Last updated July 2, 2019