B.1.6 LOI3-BIO-02 Exemplar Phone Script to Schedule Study Visits

ATTACHMENT B.1.6 Exemplar Phone Script OMB #: 0925-0593

LOI3-BIO-02 & -05 EXPIRATION DATE: 07/31/2013

PHONE CALL SCRIPT Date: ____________

Time: ____________

Participant #:____________

Postpartum day # _______

“Hello, my name is _____________ and I am the research associate for the study about breastfeeding in which you are enrolled. We need to schedule your next study visit. Before we schedule the visit, I would like to ask you some questions about your progress with lactation.”

1. Are you still breast-feeding? ( ) yes ( ) no (if yes, skip to # 3).

2. When did you stop breastfeeding?

3. Are you collecting milk by pumping your breasts? ( ) yes ( ) no

If the mother is no longer breast feeding or pumping, thank her for her participation in the study and tell her that we will not need to schedule a visit.

If the mother is still breastfeeding, go to #4.

______________________________________________________________________

4. May I schedule your next appointment to provide a breast milk sample and update your Breast Milk Study Survey?

Date: _____________

Time: ____________

What is the best location for you?

Public reporting burden for this collection of information is estimated to average 5 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-0593). Do not return the completed form to this address.

Version: 2/28/11