CDEs
Forms
State mother resides in at patient's birth
Medical coverage at time of intake
Primary language spoken at home
Number of biological siblings in the patient's family
Sibling 1: Sibling type
Sibling 1: Half
Sibling 1: Affected with this condition
Sibling 1: Enrolled in this study
Sibling 1: NBSTRN ID for this study
Sibling 1: Method of diagnosis
Sibling 1: Method of diagnosis-other, specify
Sibling 1: Newborn screen performed for this condition
Sibling 1: Results of newborn screening for this condition
Sibling 1: Diagnostic tests performed for this condition
Sibling 1: Specify the type of diagnostic tests performed
Sibling 1: Diagnostic tests performed-other, specify
Sibling 1: Deceased
Biological mother: Evidence of maternal symptoms
Specify evidence of maternal symptoms
Other affected family members NOT listed above
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32