Beth, you can make it as difficult or as easy as you need it to be for your story since the requirements vary from state to state. When my husband and I first married, we had to have a blood test that not only checked for STDs (no HIV in those days) but also immunity to German measles because it can cause such devastating birth defects. We took ours at the clinic where my childhood doctor was, and he took care of sending the necessary paperwork to the county clerk's office.
However, when we remarried some years later, no blood test was required. In fact, no minister or judge was required. All that was necessary to be married was to pay for the license and have someone in the clerk & recorder's office witness our signatures on the license.
So you can make the process as tough or easy as your story requires.
