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First Name
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Last Name
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Was your baby born premature (less than 37 weeks)?
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Was your baby given cow-based formula or fortifier (Similac or Enfamil)?
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Did your child suffer from intestinal issues after consuming Enfamil or Similac formula?
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Where was your baby born (city/state)?
What year was your baby born?
When would be a good time to call you?
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