NEWBORN SCREENING CONTACTS REQUEST

This is a request from the North Carolina State Laboratory of Public Health's Newborn Screening Program for contact information for facilities that collect newborn screening specimens and healthcare providers of newborn infants. The Laboratory will utilize this information to distribute information regarding Newborn Screening to our partners who may be impacted by announcements or updates in the program. If you have questions about this database, please contact Ann Grush at (919) 733-3937. Thank you.



  1. What is the name of your facility? If there is more than one site for your practice, please be specific.


  1. What is the type of facility for which you are responding?
    Hospital
    Physician's office
    Local health department
    Other clinic
    University/genetics facility


  1. In what area of this facility are you the contact?
    Newborn nursery
    NICU
    PICU
    Laboratory
    Outpatient laboratory
    Other


  1. Please provide your first and last names.


  1. Please provide your title or job description.


  1. Provide your telephone number, preferably a direct line. Include the area code.


  1. Provide your e-mail address. Check for accurate spelling and punctuation.


  1. Who in your facility is responsible for collection of the Newborn Screening specimen?
    Nursery
    Laboratory/Medical laboratory technologist
    Phlebotomy
    Out-patient laboratory/Medical laboratory technologist


  1. What work area in your facility is responsible for the mailing the Newborn Screening specimens?
    Mailroom
    Nursery
    Laboratory
    Out-patient laboratory
    Secretary/Clerical





Laboratory Improvement Coordinator
NC State Laboratory of Public Health