No state in the United States requires a blood test for a marriage license. Montana was the last to drop the requirement, eliminating its rubella screening for female applicants in 2019.1Montana State Legislature. House Bill No. 136 – Abolishing the Premarital Blood Test for Women Wherever you’re getting married in the country, you can skip the lab visit.
The requirement used to be nearly universal. By the mid-1950s, almost every state asked couples to submit results of a syphilis screening before a clerk would issue a license.2JAMA Network. The Premarital Law: History and a Survey of Its Effectiveness in Michigan As treatment improved and routine screening became available elsewhere in the health system, the tests stopped justifying their cost, and states repealed the laws one by one from the 1970s into the 2000s. The bill’s sponsor in Montana called the rubella rule “an antiquated test from the ’40s.”
What You Actually Need to Get a Marriage License
Both people usually have to appear in person at the marriage license office, which is typically the county clerk or register of deeds. Bring government-issued photo ID: a driver’s license, passport, or state ID card. Most offices also ask for your Social Security number. If you don’t have one, you can generally substitute a foreign passport or consular ID and sign an affidavit, though procedures vary by location.
If either of you was married before, bring proof that the earlier marriage ended. A certified copy of the divorce decree or annulment order works. If a former spouse died, a death certificate does the same job. The clerk needs to confirm every prior marriage is legally dissolved before issuing a new license.
Fees generally run from about $20 to $110, depending on the county. Some jurisdictions offer a discount if you complete a premarital counseling course. Call ahead to your specific county clerk’s office so you don’t make a wasted trip.
Waiting Periods and How Long the License Lasts
Some places impose a waiting period between when you pick up the license and when you can hold the ceremony. Where they exist, waiting periods typically run from 24 to 72 hours. Many states have none, and some that do will waive the wait in special circumstances. If you’re planning to apply and marry on the same day, confirm the local rule first.
Licenses also expire. The window ranges from as little as 30 days to as long as a year, with 60 to 90 days common. Miss that window and you’ll have to reapply and pay again. Couples with long engagements who apply too early get caught by this more often than you’d expect.
Age, Witnesses, and Who Can Officiate
Both applicants generally must be at least 18. As of late 2025, roughly 21 states limit marriage to legal adults, with some making a narrow exception for court-emancipated 16- and 17-year-olds. The remaining states allow minors to marry under varying conditions, usually with an age floor of 16 or 17 plus parental consent, judicial approval, or both. A small number of states still set no statutory minimum age.
Most states require one or two witnesses at the ceremony, though a few require none. Witnesses generally must be adults. The officiant has to be legally authorized to perform marriages in the state where the ceremony takes place; judges, magistrates, and clergy qualify in most jurisdictions. Some states also recognize friends or family members who become temporarily authorized to officiate, often through online ordination, though the legal weight of that varies.
Marrying Outside the United States
The no-blood-test rule is a U.S. rule. Several countries still require some form of premarital medical examination, which may screen for blood-borne or hereditary conditions.3PubMed Central. Getting Married in China: Pass the Medical First Saudi Arabia, for example, screens for hereditary blood disorders like sickle-cell disease and thalassemia along with infectious diseases including hepatitis B and HIV. Other countries in the Middle East, Asia, and parts of Europe run similar programs, with different tests and different consequences for a positive result.
If you’re marrying abroad, check that country’s requirements well before the trip. The exam may have to happen locally, and results from a U.S. doctor may not be accepted. The embassy or consulate website for your destination is the most reliable source for current rules.