Kernicterus Medical Questionnaire

Thank you for reaching out to our Kernicterus Center of Excellence at Children’s Mercy Hospital in Kansas City. To help us better understand your needs, please fill out the brief questionnaire below. Please let us know why you are contacting us and how we can be of service to you.

After we receive your response, we will review it and provide an initial response by email in about two weeks.


Why are you contacting the Kernicterus Center of Excellence?

Your name
Your email
Phone
Street Address
City and State
Zip code


Who are you inquiring about?

Child's Full Name
Gender
                             
Date of Birth
Relationship


Focus of Inquiry

Please check any that apply

As a newborn, was your child:

If your child was jaundiced (had hyperbilirubinemia) do you know why?

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