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  • Reason for second newborn screen
  • If other, please specify
  • State NBS serial number on second newborn screen
  • Creatine kinase.MM/Creatine kinase.total in Serum or Plasma
  • CK-MM activity result normal reference range on second newborn screen
  • CK-MM activity tissue type on second newborn screen
  • If other, please specify
  • Collection date of Specimen
  • Reason for third newborn screen
  • If other, please specify
  • Was genetic testing performed for the infant?
  • Which genetic testing was performed?
  • Upload deletion/duplication of DMD report from Emory Genetics
  • Upload mutation analysis of DMD report from Emory Genetics
  • Upload mutation analysis of other genes report from Emory Genetics
  • Upload other testing report from Emory Genetics
  • Genetic counseling provided
  • Provider of genetic counseling
  • If other, please specify
  • Maternal genetic testing done
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