Att 3i Participant Contact Log 082511

Evaluating Locally-Developed HIV Prevention Interventions for African-American MSM in Los Angeles

Attachment 3i

Participant Contact/Update Log

PARTICIPANT CONTACT/UPDATE LOG*

Month	Name (e.g., Jeff K.)	Contacted by:			New Info? (Y/N)	# of Attempts	Successful Contact Date:	Address Change? (Y/N)	Current Email Address:	Current Home Phone#	Current Cell #
		Phone	Email	Text
1
2
3
4
5
6
1
2
3
4
5
6
1
2
3
4
5
6
1
2
3
4
5
6

* *If Participant does not wish to be contacted, please write “Do Not Contact” and cross out future contact entries.