Environmental Tap Water Pesticide (TWQ) Sample Distribution Script

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Environmental Tap Water Pesticide (TWQ) Sample Distribution Script
(EH, PB, HI) V1.0



Event:
Pregnancy Visit 1

Participant:
Pregnant Woman

Domain:
Environmental

Type of Document:
Script

Recruitment Groups:
EH, PB, HI





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Environmental Tap Water TWQ Sample Distribution Script
Here is a Tap Water TWQ sample collection kit so that you may collect the TWQ sample yourself. Your collection of this TWQ sample will help us learn more about the tap water in homes. Also, it will help us learn if participants have problems with the procedures for collecting tap water samples, so that one day we may mail the kits to participants directly. 
To collect the TWQ sample, you will fill two bottles with water from your kitchen faucet or other tap and complete the Tap Water TWQ Questionnaire.
You will then package the bottles on ice packs and ship them to the designated laboratory by FedEx using the pre-paid, self-addressed Fedex label and shipping container provided. 
The Tap Water TWQ Questionnaire will be mailed to our office by regular mail in the enclosed pre-paid, self-addressed envelope. 
Please place the ice packs provided in the kit in your freezer as soon as possible. Ice packs should be frozen when you ship the TWQ sample.
If possible, on the day of sample collection, before collecting the sample, avoid handling or using the following: caffeine, tobacco, home cleaning agents, or personal care products, such as antibacterial soaps, hand sanitizers, or lotions.
It is important that you complete the collection of each sample before starting the collection of other samples. Please keep the TWQ sample separate from TWF sample to avoid mixing of two different samples. TWQ and TWF samples should be packaged and shipped to the designated laboratories in separate shippers.
Do you have any questions about the Tap Water TWQ sample collection kit?

IF ASKED WHAT TWQ MEANS: TWQ is a code for the laboratory so they know the difference in the two sample types collected. There are two sample codes – a TWQ and a TWF sample. 
THIS SCRIPT MAY BE MODIFIED AS APPROPRIATE IF OTHER ENVIRONMENTAL SAMPLE COLLECTION KITS ARE BEING DISTRIBUTED AT THIS VISIT.