Report a lead test (Providers only)

Please select a lead test reporting method
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Status message

For this reporting method, you must use the most recent version of the CDPHE Lead Reporting Spreadsheet (Last updated 4/15/2021). Complete all required fields for each case.

Upload requirements
Does this spreadsheet contain any elevated (≥3.5 μg/dL) test results?

Test Information

Specimen type
μg/dL
Enter a numeric value in μg/dL. If the result is below detection, enter the test detection limit preceded by the "<" sign (e.g. <3.3). If the test detection limit is unknown, enter "Low" or  "Not detected." 

Patient Information

Sex
Race (select all that apply)
Ethnicity
Address

Provider Information

Enter the name of the individual healthcare provider who ordered the lead test.

 
Enter the name of the healthcare practice where the test was ordered.
Clinic/Practice address

Additional Information (Elevated cases)

The case management contact should be a medical professional (MD, RN, etc.) participating in the patient's care that CDPHE can contact for case status updates.
Patient name (first and last) Parent/Guardian name Case management contact Case management phone Case management email Preferred contact method Operations
Preferred contact method
Upload requirements
Add additional information relevant to this report.

Report Submission Information

Complete these fields if you are submitting this report from a laboratory or if the information differs from "Clinic/Practice" entered above.