The storage and use of newborn babies’ blood spot cards: a public consultation

Details of respondents

We would like to know more about you, to allow us to take into account the range of people
responding to this consultation. All personal information will be stored securely and will only
be accessed by the research team. We will only report your responses if you give us your
permission to do so, and if you prefer us to only do this anonymously, we will adhere to your
wishes. Please indicate your preferences below.

Please complete and return with your responses by 6^th January 2006

Name:

Organisation:

Address: (optional)¹

Telephone:
Email:

Are you responding individually on your own behalf, or on behalf of your
organisation?

□ Individual

□ Organisation

Please tick which description(s) best describe you:

A newborn screening provider:

□ A health professional involved in screening, or their representative

□ A national or international screening organisation

A child, parent or other family member:

□ A child or young person under the age of 18 unaffected by the screened
conditions

□ A child or young person under the age of 18 affected by the screened
conditions

□ A parent of a child unaffected by the screened conditions

□ A parent of a child affected by one of the screened conditions

□ A family member (other than a parent) of a child unaffected by the screened
conditions

¹ Please note that if we do not have your address we will not be able to send you a copy of the
report when it is published.

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