Att C2a_Cover letter -- follow-up clinic survey

Date

Clinic staff name

Clinic name

Dear [Clinical Staff’s name]:

As you know, [Clinic name] is one of 18 Illinois clinics serving National Breast and Cervical Cancer Early Detection Program (NBCCEDP) patients that the Centers for Disease Control and Prevention (CDC) selected to participate in the CDC Cervical Cancer Study (Cx3 Study). The Cx3 Study is a pilot study to provide HPV DNA tests, along with Pap tests, for cervical cancer screening in women 35-60 years of age. The study results will help CDC to decide whether or not to provide HPV testing along with Pap testing to screen for cervical cancer in the CDC Breast and Cervical Cancer Early Detection Program across the country.

As part of the study, the Battelle Centers for Public Health Research and Evaluation is conducting a survey of all participating clinics each month during the first year of the study. Please complete the enclosed survey on behalf of the [clinic name] for the month of [month, 200x]. The survey includes questions about the staff time associated with participating in the CDC Cx3 Study during the past month. It may be necessary for you to consult records or other clinic staff to complete the survey. The survey will take approximately one hour to complete.

This survey has been sent to each of the 18 clinics participating in the Cx3 Study. We need responses from every clinic to make this important study valid. Your responses will be private. Please do not put your name on the survey. We will not identify any person who was in the study in any papers or reports. The information provided by you and staff at the other participating clinics will provide valuable information to CDC to assist them in their efforts to provide cervical cancer screening to NBCCEDP women.

When you have completed the survey, please seal it in the envelope provided and return it in the enclosed self-address, postage paid envelope. If you have any questions about this research study, please call the Battelle Task Leader, Diane Manninen, Ph.D., at 1-206-528-3140. If you have any questions or concerns about your rights as a human subject in this study, you may call the Battelle Human Subject Representative at 1-877-810-9530, extension 500.

Thank you for your time and participation in this important study.

Sincerely,

Vicki Benard

CDC Division of Cancer Prevention and Control

Appendix C2a. Cover letter – follow-up clinic survey