No, you do not have to do a blood test to get married anywhere in the United States. Montana was the last state to drop the requirement when it repealed its rubella screening law for women in 2019, and every other state abandoned premarital blood testing years or decades earlier.1Montana State Legislature. House Bill No. 136 What a clerk’s office will ask for today is government-issued identification, proof of age, and a licensing fee.
Why Blood Tests Used To Be Required
Premarital blood testing began as a public health measure aimed primarily at catching syphilis before couples married and had children. Congenital syphilis caused severe birth defects, and before widespread antibiotic treatment, screening engaged couples looked like a reasonable way to limit transmission. Some states also screened for gonorrhea or rubella. By 1954, 40 states plus the territories of Alaska and Hawaii had premarital health examination laws on the books.2CDC. Premarital Health Examination Legislation
Those laws started falling away in the 1970s. Mandatory screening caught very few new cases relative to the cost it imposed on every couple applying for a license. Better treatments and more targeted public health strategies made blanket testing harder to justify, and states repealed the laws one by one over the following decades.
The One State With a Blood Test Statute Still on the Books
New York has a single health-related provision tied to marriage licensing. Under Domestic Relations Law Section 13-aa, applicants who are not classified as Caucasian, Indian, or “Oriental” (the statute’s outdated terminology) are supposed to be offered a blood test for sickle cell anemia. The law dates to 1972, and its racially targeted language has drawn criticism, but it has not been repealed.3New York State Senate. New York Domestic Relations Law DOM 13-AA
Two features keep this from functioning as an actual barrier. A positive result cannot be used to deny a marriage license, and anyone can decline the test on religious grounds. In practice, it’s an advisory screening, not a prerequisite to getting married.
Health Pamphlets Instead of Blood Draws
Several states replaced blood tests with something far lighter: handing out informational brochures about sexually transmitted infections, particularly HIV and AIDS. The clerk’s office gives you a pamphlet or asks you to sign a statement confirming you received one. No needle, no lab visit, and the information has no bearing on whether your license is approved.
The specific states have shifted over time, but Texas, Illinois, Indiana, Michigan, and Virginia are among those that require clerks to distribute STD or HIV educational materials during licensing. Some states also include information about genetic conditions or domestic violence resources. None of these requirements involve medical testing.
What You Actually Need To Get a Marriage License
Since blood tests are off the table, most jurisdictions will ask you to bring the following when you apply:
- Government-issued photo ID. A driver’s license, state-issued ID card, or passport. Both applicants need to present one.
- Proof of age. Your ID usually covers it, but some offices accept a birth certificate as backup. Both parties generally need to be at least 18, though a handful of states allow younger applicants with parental consent or a court order. Nebraska sets the general age of majority at 19, and Mississippi requires parental consent for anyone under 21.
- Social Security number. Many states ask for it on the application. If you don’t have one, some jurisdictions let you submit a sworn affidavit stating you’ve never been issued a number.
- Proof that prior marriages ended. If either person was previously married, you’ll typically need a certified divorce decree or a death certificate for the former spouse.
- A licensing fee. Fees vary widely by jurisdiction, running roughly $20 to $110, with most counties falling in the $30 to $75 range.
Both applicants usually need to appear together at the clerk’s office, though a growing number of jurisdictions now accept online applications for at least part of the process. If you’re applying in New York, expect the sickle cell screening to be offered; you can decline it and still walk out with a license.