Form 1 Telephone Client-Customer Service Questions

Collection of Customer Service, Demographic and Smoking/Tobacco Use Information from NCI Cancer Information Service (CIS) Clients

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0925-0208 can be found here:

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APPENDIX 2 A

DATA COLLECTION INSTRUMENTS and

electronic contact Record Form (ECRF)

TELEPHONE Questions

(customer service and demographics questions)