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Forms

F09-11709: Child Blood Lead Reporting Form
Used by healthcare providers to report blood lead level(s) for children under 15 years of age.

F09-11624: Adult Blood Lead Reporting Form
Used by healthcare providers to report blood lead level(s) for children/adults 15 years of age and older.

Pb-100: Possible Sources of Lead Exposure: Interview Questions - Revised 01/04/12
Used by healthcare providers to interview the parent/guardian of a child with a diagnostic elevated blood lead level to determine possible source(s) of lead exposure.

Pb-101: Request for Environmental Investigation - Revised 02/23/12
Used by healthcare providers to request and Environmental Lead Investigation for a child with a venous blood lead level test result of 20 mcg/dL and higher, or two separate venous BLL tests collected at least 12 weeks apart in the 10-19 mcg/dL range.

Pb-102: Follow-up of an Elevated Blood Lead Level - Revised 01/04/12
Used by healthcare providers for follow-up of elevated blood lead levels of a child.

Pb-103: Elevated Blood Lead Level Investigation Questionnaire - Revised 04/26/11
Used by Lead Risk Assessors to conduct Environmental Lead Investigations.

Pb-104: Physician Checklist for Parent Education Topics
Used by healthcare providers to determine the appropriate lead educational material to provide parents for medical care, environmental intervention, and nutritional intervention.

Pb-109: Reference for Follow-up Blood Lead Testing and Medical Case Management - Effective 05/01/2013 
Used by healthcare providers to determine when follow-up blood lead testing is necessary. Specifically: “Schedule for Obtaining a Diagnostic Venous sample”, “Schedule for Follow-up Venous Blood Lead Testing After Diagnostic Venous Sample”, and “Recommendations for Children with Diagnostic Elevated Blood Lead Levels”.

Pb-110: Lead Risk Questionnaire (English Version) - Revised 12/22/2011
Pb-110: Lead Risk Questionnaire (Spanish Version) - Revised 11/18/2011
The lead risk questionnaire is located on page 2 of the "Texas Childhood Blood Lead Screening Guidelines: Quick Reference Guide."

Pb-111: Point-Of-Care Blood Lead Testing Report- Created 04/26/12
Used by healthcare providers to report blood lead levels when using an point-of-care blood lead analyzer.


Literature & Publications

1-312: Educator's Brochure: What all New Parents Need to Know…

1-313: Childhood Blood Lead Testing: Getting a Good Specimen (Poster)

1-314: Your Local Childhood Lead Poisoning Prevention Program (CLPPP) Is Here to Help You

TX CLPPP Newsletters for Health Care Providers

Lead Information Sheets for Parents

Lead Poisoning Prevention Guidelines for Prenatal Care Providers in Texas

Blood Lead Testing in Texas: Reporting Information for Providers (pdf 136 KB)


Screening & Testing

The updated Texas Childhood Blood Lead Screening Guidelines now gives healthcare providers the option to use census tracts or zip codes to determine if a child lives in a targeted area.

Following the Centers for Disease Control and Prevention (CDC) recommendations, the following criteria was used to determine targeted areas:
• Areas with ≥27% of housing built before 1950, and
• Areas with ≥3% of children tested for lead at ages 1 and 2 with a blood lead level ≥10 mcg/dL.


 

Reporting, Laws & Administrative Code

In accordance with the Texas Health and Safety Code, Chapter 88, the Texas Childhood Lead Poisoning Prevention Program (TX CLPPP) implements the law by maintaining a registry of blood lead results, analyzing data, and conducting lead poisoning prevention activities.

The Texas Administrative Code (Title 25, Part 1, Chapter 37, Rule §37.334) requires the reporting of all blood lead levels, elevated and non-elevated, for children 14 years of age or younger. Physicians, laboratories, hospitals, clinics, and other healthcare facilities must report all blood lead tests to the Texas Department of State Health Services, Childhood Lead Poisoning Prevention Program.


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Contact Us by Email

Mailing Address
PO Box 149347, MC 1964
Austin, Texas 78714-9347

Phone: 512-776-7151
Fax: 512-776-7699

 

Last updated July 18, 2014