Newborn Screening: Critical Congenital Heart Disease Conflict of Interest Disclosure Report
Wisconsin health care providers can nominate a condition to add to the Wisconsin newborn screening panel. The panel is part of the Wisconsin Newborn Screening program. Part of the process involves submitting a nomination packet.
Nominators and co-sponsors must fill out and submit the form, Newborn Screening Program Conflict of Interest Disclosure, F-00986A. (PDF) Below, we include a report of the forms we received for the critical congenital heart disease nomination.
Conflict of interest disclosure report records
The following people or groups submitted a conflict of interest disclosure form for the critical congenital heart disease nomination.
John Hokanson (nominator)
University of Wisconsin-Madison
Department of Pediatrics
May 2, 2014
No conflict of interest reported
Amy Basken
Pediatric Congenital Heart Association
April 28, 2014
No conflict of interest reported
Steward Berger
Children’s Hospital of Wisconsin
April 25, 2014
No conflict of interest reported
Lyann Bueno-Franco
Mended Little Hearts of Milwaukee
April 29, 2014
No conflict of interest reported
Anthony DeFranco
Wisconsin Chapter American College of Cardiology
April 28, 2014
No conflict of interest reported
Gina Dennik-Champion
Wisconsin Nurses Association
May 7, 2014
No conflict of interest reported
Deb Gerrits
Mended Little Hearts of Southern Wisconsin
May 1, 2014
No conflict of interest reported
Nicole Hudzinski
American Heart Association
April 19, 2014
No conflict of interest reported
Maureen Kartheiser
March of Dimes Foundation
April 25, 2014
No conflict of interest reported
Kia LaBracke
Wisconsin Chapter American Academy of Pediatricians
April 28, 2014
No conflict of interest reported
J. Carter Ralphe
University of Wisconsin Health—American Family Children’s Hospital
May 5, 2014
No conflict of interest reported
John R. Raymond
Medical College of Wisconsin
April 25, 2014
No conflict of interest reported
To request copies of the signed and submitted conflict of interest disclosure forms, email DHSWICongenitalDisorders@dhs.wisconsin.gov.