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[{"$nulls":4},"Form Approved"]
[{"$nulls":4},"OMB No. 0920-0879"]
[{"$nulls":4},"Exp. Date 01/31/2021"]
[]
[" Newborn Screening Quality Assurance Program"]
[]
["Spinal Muscular Atrophy (SMA) Pilot Proficiency Testing Program Customer Feedback"]
[]
["Instructions"]
["1) Enter your lab code number in the lab code box"]
["2) For questions 1 - 4 select:"]
["\"NO Improvement Needed\" if you are fully satisfied (95 - 100%) or"]
["\"SOME Improvement Needed\" if you are mostly satisfied (75 - 94%) or"]
["\"MUCH Improvement Needed\" if you are not satisfied (<75%) or"]
["\"N/A\" if unable to assess"]
["3) If you select \"SOME Improvement Needed\" or \"MUCH Improvement Needed\", briefly describe the improvements that you think are needed."]
[]
["Lab Code:"]
[]
[null,"NO Improvement Needed","SOME Improvement Needed","MUCH Improvement Needed","N/A"]
["1. SMA PT Instruction Form"]
[]
[]
["2. SMA PT Data Reporting Form"]
[]
[]
[]
[]
["3. Data submission process"]
[]
[]
["4. DBS Panel"]
[]
[]
[]
["5. Where improvement is needed, please provide suggestions:"]
["Open-ended response"]