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☐ DVT/PE or Maternal thrombophilia ☐ Antiphospholipid Syndrome ☐ Factor V Leiden mutation ☐ Antithrombin III deficiency ☐ Protein C/Protein S deficiency ☐ Prothrombin gene mutation ☐ Other _____ ☐ Genetic diseases ☐ Cystic Fibrosis ☐ Known carrier of Spinal Muscular Atrophy (SMA) ☐ Tay-Sachs ................
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