Interviewer: _______________
Date: _______________
Letter sent: _______________
Reconfirmation Call: _______________ |
|
Group 1: _________
Group 2: _________
Group 3: __________
Group 4: __________ |
ScreenerS for ONC Consumer Focus Groups – Baltimore, MD
Tuesday:
Group 1: 5:30-7:00 p.m. – Caregivers of adults [RECRUIT 9]
Group 2: 7:30-9:00 p.m. – Diabetes patients [RECRUIT 9]
Wednesday:
Group 3: 5:30-7:00 p.m. – Cardiovascular disease patients [RECRUIT 9]
Group 4: 7:30-9:00 p.m. – Cancer survivors [RECRUIT 9]
GROUP 1: CAREGIVERS
Hello, I’m ___________ with _____________, an independent marketing research firm. We are not selling any product or service. We are conducting a research study on behalf of the U.S. Department of Health and Human Services (HHS) and would like to include your views. The research is about electronic health records and other forms of health information technology. The session will not focus on any specific medical condition, but instead will focus on how health information technology can help people manage their health care and the health care of family, friends and others in their care. My questions will only take a few minutes. May I speak with (name)?
1. First, do you, or does any member of your household or immediate family, work for or is retired from:
A market research company _____
A direct mail company or direct marketing company _____
An advertising agency or public relations firm _____
[IF YES TO ANY >> TERMINATE]
2. Do you provide care for a friend or family member who has been diagnosed with a chronic health condition such as diabetes, heart disease, high blood pressure, atrial fibrillation, stroke, cancer, asthma, Alzheimer’s, or arthritis? Providing care may include helping the patient make decisions about treatments and other aspects of health care. It may also include helping the patient take medications and follow doctor’s instructions for treatment.
Yes_____
[TERMINATE] No _____
3. Do you currently help the adult person for whom you are providing care by keeping track of his or her health/medical information?
Yes_____
[TERMINATE] No _____
4. How comfortable are you in using the Internet to look for information about health topics or medical conditions?
Very comfortable _____
Somewhat comfortable _____
Not very comfortable _____
[TERMINATE] Not at all comfortable _____
5. Which of the following categories best describes your total annual household income? [ATTEMPT MIX]
Under $15,000 _____
$15,000 - $34,999 _____
$35,000 - $54,999 _____
$55,000 - $74,999 _____
$75,000 - $100,000 _____
Over $100,000 _____
6. Please tell me your age. [ATTEMPT MIX]
7. What is your current marital status? Are you ….. ?
Married or living with a partner_____
Single _____
Divorced _____
Widowed _____
8. What is the highest level of education you have completed? [ATTEMPT MIX]
Less than high school graduate _____
High school graduate _____
Some college _____
Post graduate studies or degree _____
9. So that we can be sure that all backgrounds are represented in our study, please tell me your ethnic or race background. Are you … ?
[ATTEMPT 2-3 MINORITIES]
Ethnicity
Hispanic or Latino_____
Not Hispanic or Latino_____
Race
American-Indian or Alaska Native _____
Asian _____
Black or African American _____
Native Hawaiian-Indian or Other Pacific Islander _____
White _____
Other _____
10. [Record gender] [ATTEMPT MIX]
Male _____
11. Have you ever attended a focus group discussion or individual interview? By that we mean an informal, round-table discussion, conducted by a professional moderator in which you were asked your opinions regarding a product, a service, or advertising?
MAX. ½ GROUP >> ASK A-B >> Yes _____
INVITE TO GROUP >> No _____
How many of these groups have you attended?
______________________________ [MAX. 4 EVER]
How long ago was the last one of these groups you attended?
______________________________ [MUST BE AT LEAST 6 MONTHS AGO]
[INVITE TO GROUP]
[INVITE TO GROUP]
Thank you for answering my questions. As I mentioned, we are conducting a study about electronic health records and health information technology on behalf of the U.S. Department of Health and Human Services. Your input is critical to the success of the project.
In order to accomplish our research objective, we would like to invite you to take part in an informal, group discussion to be conducted on [DATE] at 5:30 P.M. The discussion will be led by a professional moderator and will last 1.5 hours or less. We are confident that you will enjoy the exchange of information and will find it beneficial.
As a token of appreciation for sharing your views, you will receive a $100 cash incentive at the time of the discussion.
We can only invite a select number of participants to take part. Can we schedule your participation?
[If yes, read…..]
If you need glasses for reading or watching TV, please bring them with you to the discussion.
[Record Group]
Group/Date/Time:
ID# _______________________________________________________________
NAME: _________________________________________________
ADDRESS: _________________________________________________
CITY: _________________________________________________
ZIP CODE: _________________________________________________
PHONE: (DAY) ( )___________________________________
(EVE) ( )___________________________________
(FAX) ( )___________________________________
(CELL) ( )____________________________________
(EMAIL) ___________________________________________
GROUP 2: DIABETES PATIENTS
Hello, I’m ___________ with _____________, an independent marketing research firm. We are not selling any product or service. We are conducting a research study on behalf of the U.S. Department of Health and Human Services (HHS) and would like to include your views. The research is about electronic health records and other forms of health information technology. The session will not focus on any specific medical condition, but instead will focus on how health information technology can help people manage their health care and the health care of family, friends and others in their care. My questions will only take a few minutes. May I speak with (name)?
1. First, do you, or does any member of your household or immediate family, work for or is retired from:
A market research company _____
A direct mail company or direct marketing company _____
An advertising agency or public relations firm _____
[IF YES TO ANY >> TERMINATE]
2. Has a physician or other health care provider diagnosed you with diabetes?
Yes_____
[TERMINATE] No _____
3. How long have you been diagnosed with diabetes?
Less than one year _____
1-3 years _____
4-5 years _____
More than 5 years _____
4. Do you currently keep track of your health care by saving paper copies of your test results, doctor’s instructions, or other information?
Yes_____
[TERMINATE] No _____
5. How comfortable are you in using the Internet to look for information about health topics or medical conditions?
Very comfortable _____
Somewhat comfortable _____
Not very comfortable _____
[TERMINATE] Not at all comfortable _____
6. Which of the following categories best describes your total annual household income? [ATTEMPT MIX]
Under $15,000 _____
$15,000 - $34,999 _____
$35,000 - $54,999 _____
$55,000 - $74,999 _____
$75,000 - $100,000 _____
Over $100,000 _____
7. Please tell me your age. [ATTEMPT MIX]
8. What is your current marital status? Are you ….. ?
Married or living with a partner_____
Single _____
Divorced _____
Widowed _____
9. What is the highest level of education you have completed? [ATTEMPT MIX]
Less than high school graduate _____
High school graduate _____
Some college _____
Post graduate studies or degree _____
10. So that we can be sure that all backgrounds are represented in our study, please tell me your ethnic or race background. Are you … ?
[ATTEMPT 2-3 MINORITIES]
Ethnicity
Hispanic or Latino_____
Not Hispanic or Latino_____
Race
American-Indian or Alaska Native _____
Asian _____
Black or African American _____
Native Hawaiian-Indian or Other Pacific Islander _____
White _____
Other _____
11. [Record gender] [ATTEMPT MIX]
Male _____
12. Have you ever attended a focus group discussion or individual interview? By that we mean an informal, round-table discussion, conducted by a professional moderator in which you were asked your opinions regarding a product, a service, or advertising?
MAX. ½ GROUP >> ASK A-B >> Yes _____
INVITE TO GROUP >> No _____
How many of these groups have you attended?
______________________________ [MAX. 4 EVER]
How long ago was the last one of these groups you attended?
______________________________ [MUST BE AT LEAST 6 MONTHS AGO]
[INVITE TO GROUP]
[INVITE TO GROUP]
Thank you for answering my questions. As I mentioned, we are conducting a study about electronic health records and health information technology on behalf of the U.S. Department of Health and Human Services. Your input is critical to the success of the project.
In order to accomplish our research objective, we would like to invite you to take part in an informal, group discussion to be conducted on [DATE] at 7:30 P.M. The discussion will be led by a professional moderator and will last 1.5 hours or less. We are confident that you will enjoy the exchange of information and will find it beneficial.
As a token of appreciation for sharing your views, you will receive a $100 cash incentive at the time of the discussion.
We can only invite a select number of participants to take part. Can we schedule your participation?
[If yes, read…..]
If you need glasses for reading or watching TV, please bring them with you to the discussion.
[Record Group]
Group/Date/Time:
ID# _______________________________________________________________
NAME: _________________________________________________
ADDRESS: _________________________________________________
CITY: _________________________________________________
ZIP CODE: _________________________________________________
PHONE: (DAY) ( )___________________________________
(EVE) ( )___________________________________
(FAX) ( )___________________________________
(CELL) ( )____________________________________
(EMAIL) ___________________________________________
GROUP 3: CARDIOVASCULAR DISEASE PATIENTS
Hello, I’m ___________ with _____________, an independent marketing research firm. We are not selling any product or service. We are conducting a research study on behalf of the U.S. Department of Health and Human Services (HHS) and would like to include your views. The research is about electronic health records and other forms of health information technology. The session will not focus on any specific medical condition, but instead will focus on how health information technology can help people manage their health care and the health care of family, friends and others in their care. My questions will only take a few minutes. May I speak with (name)?
1. First, do you, or does any member of your household or immediate family, work for or is retired from:
A market research company _____
A direct mail company or direct marketing company _____
An advertising agency or public relations firm _____
[IF YES TO ANY >> TERMINATE]
2. Has a physician or other health care provider diagnosed you with heart disease or hypertension? This may include coronary heart disease, heart failure, congenital heart disease, stroke, hypertension, heart valve disease, or atrial fibrillation.
Yes_____
[TERMINATE] No _____
[ATTEMPT MIX OF CONDITIONS]
3. How long have you been diagnosed with heart disease or hypertension?
Less than one year _____
1-3 years _____
4-5 years _____
More than 5 years _____
4. Do you currently keep track of your health care by saving paper copies of your test results, doctor’s instructions, or other information?
Yes_____
[TERMINATE] No _____
5. How comfortable are you in using the Internet to look for information about health topics or medical conditions?
Very comfortable _____
Somewhat comfortable _____
Not very comfortable _____
[TERMINATE] Not at all comfortable _____
6. Which of the following categories best describes your total annual household income? [ATTEMPT MIX]
Under $15,000 _____
$15,000 - $34,999 _____
$35,000 - $54,999 _____
$55,000 - $74,999 _____
$75,000 - $100,000 _____
Over $100,000 _____
7. Please tell me your age. [ATTEMPT MIX]
8. What is your current marital status? Are you ….. ?
Married or living with a partner_____
Single _____
Divorced _____
Widowed _____
9. What is the highest level of education you have completed? [ATTEMPT MIX]
Less than high school graduate _____
High school graduate _____
Some college _____
Post graduate studies or degree _____
10. So that we can be sure that all backgrounds are represented in our study, please tell me your ethnic or race background. Are you … ?
[ATTEMPT 2-3 MINORITIES]
Ethnicity
Hispanic or Latino_____
Not Hispanic or Latino_____
Race
American-Indian or Alaska Native _____
Asian _____
Black or African American _____
Native Hawaiian-Indian or Other Pacific Islander _____
White _____
Other _____
11. [Record gender] [ATTEMPT MIX]
Male _____
12. Have you ever attended a focus group discussion or individual interview? By that we mean an informal, round-table discussion, conducted by a professional moderator in which you were asked your opinions regarding a product, a service, or advertising?
MAX. ½ GROUP >> ASK A-B >> Yes _____
INVITE TO GROUP >> No _____
How many of these groups have you attended?
______________________________ [MAX. 4 EVER]
How long ago was the last one of these groups you attended?
______________________________ [MUST BE AT LEAST 6 MONTHS AGO]
[INVITE TO GROUP]
[INVITE TO GROUP]
Thank you for answering my questions. As I mentioned, we are conducting a study about electronic health records and health information technology on behalf of the U.S. Department of Health and Human Services. Your input is critical to the success of the project.
In order to accomplish our research objective, we would like to invite you to take part in an informal, group discussion to be conducted on [DATE] at 5:30 P.M. The discussion will be led by a professional moderator and will last 1.5 hours or less. We are confident that you will enjoy the exchange of information and will find it beneficial.
As a token of appreciation for sharing your views, you will receive a $100 cash incentive at the time of the discussion.
We can only invite a select number of participants to take part. Can we schedule your participation?
[If yes, read…..]
If you need glasses for reading or watching TV, please bring them with you to the discussion.
[Record Group]
Group/Date/Time:
ID# _______________________________________________________________
NAME: _________________________________________________
ADDRESS: _________________________________________________
CITY: _________________________________________________
ZIP CODE: _________________________________________________
PHONE: (DAY) ( )___________________________________
(EVE) ( )___________________________________
(FAX) ( )___________________________________
(CELL) ( )____________________________________
(EMAIL) ___________________________________________
GROUP 4: CANCER SURVIVORS
Hello, I’m ___________ with _____________, an independent marketing research firm. We are not selling any product or service. We are conducting a research study on behalf of the U.S. Department of Health and Human Services (HHS) and would like to include your views. The research is about electronic health records and other forms of health information technology. The session will not focus on any specific medical condition, but instead will focus on how health information technology can help people manage their health care and the health care of family, friends and others in their care. My questions will only take a few minutes. May I speak with (name)?
1. First, do you, or does any member of your household or immediate family, work for or is retired from:
A market research company _____
A direct mail company or direct marketing company _____
An advertising agency or public relations firm _____
[IF YES TO ANY >> TERMINATE]
2. Has a physician or other health care provider ever diagnosed you with any of the following types of cancer: prostate, breast, colon, lymphoma (Hodgkins or non-Hodgkins), non-melanoma skin cancer, or thyroid cancer?
Yes_____
[TERMINATE] No _____
Note which type of cancer [NEED MIX OF TYPES]
Prostate _____
Breast _____
Colon _____
Lymphoma _____
Non-melanoma skin cancer _____
Thyroid _____
3. How long ago was your diagnosis?
Less than one year _____
1-3 years _____
4-5 years _____
More than 5 years _____
4. Are you currently in remission?
Yes_____
[TERMINATE] No _____
5. Do you currently keep track of your health care by saving paper copies of your test results, doctor’s instructions, or other information?
Yes_____
[TERMINATE] No _____
6. How comfortable are you in using the Internet to look for information about health topics or medical conditions?
Very comfortable _____
Somewhat comfortable _____
Not very comfortable _____
[TERMINATE] Not at all comfortable _____
7. Which of the following categories best describes your total annual household income?
Under $15,000 _____
$15,000 - $34,999 _____
$35,000 - $54,999 _____
$55,000 - $74,999 _____
$75,000 - $100,000 _____
Over $100,000 _____
8. Please tell me your age.
9. What is your current marital status? Are you ….. ?
Married or living with a partner_____
Single _____
Divorced _____
Widowed _____
10. What is the highest level of education you have completed? [ATTEMPT MIX]
Less than high school graduate _____
High school graduate _____
Some college _____
Post graduate studies or degree _____
11. So that we can be sure that all backgrounds are represented in our study, please tell me your ethnic or race background. Are you … ?
[ATTEMPT 2-3 MINORITIES]
Ethnicity
Hispanic or Latino_____
Not Hispanic or Latino_____
Race
American-Indian or Alaska Native _____
Asian _____
Black or African American _____
Native Hawaiian-Indian or Other Pacific Islander _____
White _____
Other _____
12. [Record gender]
Male _____
13. Have you ever attended a focus group discussion or individual interview? By that we mean an informal, round-table discussion, conducted by a professional moderator in which you were asked your opinions regarding a product, a service, or advertising?
MAX. ½ GROUP >> ASK A-B >> Yes _____
INVITE TO GROUP >> No _____
How many of these groups have you attended?
______________________________ [MAX. 4 EVER]
How long ago was the last one of these groups you attended?
______________________________ [MUST BE AT LEAST 6 MONTHS AGO]
[INVITE TO GROUP]
[INVITE TO GROUP]
Thank you for answering my questions. As I mentioned, we are conducting a study about electronic health records and health information technology on behalf of the U.S. Department of Health and Human Services. Your input is critical to the success of the project.
In order to accomplish our research objective, we would like to invite you to take part in an informal, group discussion to be conducted on [DATE] at 7:30 P.M. The discussion will be led by a professional moderator and will last 1.5 hours or less. We are confident that you will enjoy the exchange of information and will find it beneficial.
As a token of appreciation for sharing your views, you will receive a $125 cash incentive at the time of the discussion.
We can only invite a select number of participants to take part. Can we schedule your participation?
[If yes, read…..]
If you need glasses for reading or watching TV, please bring them with you to the discussion.
[Record Group]
Group/Date/Time:
ID# _______________________________________________________________
NAME: _________________________________________________
ADDRESS: _________________________________________________
CITY: _________________________________________________
ZIP CODE: _________________________________________________
PHONE: (DAY) ( )___________________________________
(EVE) ( )___________________________________
(FAX) ( )___________________________________
(CELL) ( )____________________________________
(EMAIL) ___________________________________________
Interviewer: _______________
Date: _______________
Letter sent: _______________
Reconfirmation Call: _______________ |
|
Group 1: _________
Group 2: _________
|
ScreenerS for ONC Consumer Focus Groups – Bethesda, MD
Thursday:
Group 1: 4:30-6:00 – Seniors (Medicare recipients) [RECRUIT 9]
Group 2: 6:30-8:00 – Mothers of child(ren) under 18 [RECRUIT 9]
GROUP 1: SENIORS/MEDICARE BENEFICIARIES
Hello, I’m ___________ with _____________, an independent marketing research firm. We are not selling any product or service. We are conducting a research study on behalf of the U.S. Department of Health and Human Services (HHS) and would like to include your views. The research is about electronic health records and other forms of health information technology. The session will not focus on any specific medical condition, but instead will focus on how health information technology can help people manage their health care and the health care of family, friends and others in their care. My questions will only take a few minutes. May I speak with (name)?
1. First, do you, or does any member of your household or immediate family, work for or is retired from:
A market research company _____
A direct mail company or direct marketing company _____
An advertising agency or public relations firm _____
[IF YES TO ANY >> TERMINATE]
2. Are you eligible for or do you currently receive Medicare benefits?
Yes_____
[TERMINATE] No _____
3. Do you currently keep track of your health care by saving paper copies of your test results, doctor’s instructions, or other information?
Yes_____
[TERMINATE] No _____
4. How comfortable are you in using the Internet to look for information about health topics or medical conditions?
Very comfortable _____
Somewhat comfortable _____
Not very comfortable _____
[TERMINATE] Not at all comfortable _____
5. Which of the following categories best describes your total annual household income? [ATTEMPT MIX]
Under $15,000 _____
$15,000 - $34,999 _____
$35,000 - $54,999 _____
$55,000 - $74,999 _____
$75,000 - $100,000 _____
Over $100,000 _____
6. Please tell me your age. [SHOULD BE 65+; IF LESS THAN 65, TERMINATE]
7. What is your current marital status? Are you ….. ?
Married or living with a partner_____
Single _____
Divorced _____
Widowed _____
8. What is the highest level of education you have completed? [ATTEMPT MIX]
Less than high school graduate _____
High school graduate _____
Some college _____
Post graduate studies or degree _____
9. So that we can be sure that all backgrounds are represented in our study, please tell me your ethnic or race background. Are you … ?
[ATTEMPT 2-3 MINORITIES]
Ethnicity
Hispanic or Latino_____
Not Hispanic or Latino_____
Race
American-Indian or Alaska Native _____
Asian _____
Black or African American _____
Native Hawaiian-Indian or Other Pacific Islander _____
White _____
Other _____
10. [Record gender] [ATTEMPT MIX]
Male _____
11. Have you ever attended a focus group discussion or individual interview? By that we mean an informal, round-table discussion, conducted by a professional moderator in which you were asked your opinions regarding a product, a service, or advertising?
MAX. ½ GROUP >> ASK A-B >> Yes _____
INVITE TO GROUP >> No _____
How many of these groups have you attended?
______________________________ [MAX. 4 EVER]
How long ago was the last one of these groups you attended?
______________________________ [MUST BE AT LEAST 6 MONTHS AGO]
[INVITE TO GROUP]
[INVITE TO GROUP]
Thank you for answering my questions. As I mentioned, we are conducting a study about electronic health records and health information technology on behalf of the U.S. Department of Health and Human Services. Your input is critical to the success of the project.
In order to accomplish our research objective, we would like to invite you to take part in an informal, group discussion to be conducted on [DATE] at 4:30 P.M. The discussion will be led by a professional moderator and will last 1.5 hours or less. We are confident that you will enjoy the exchange of information and will find it beneficial.
As a token of appreciation for sharing your views, you will receive a $100 cash incentive at the time of the discussion.
We can only invite a select number of participants to take part. Can we schedule your participation?
[If yes, read…..]
If you need glasses for reading or watching TV, please bring them with you to the discussion.
[Record Group]
Group/Date/Time:
ID# _______________________________________________________________
NAME: _________________________________________________
ADDRESS: _________________________________________________
CITY: _________________________________________________
ZIP CODE: _________________________________________________
PHONE: (DAY) ( )___________________________________
(EVE) ( )___________________________________
(FAX) ( )___________________________________
(CELL) ( )____________________________________
(EMAIL) ___________________________________________
GROUP 2: MOTHERS OF CHILD(REN) UNDER 18
Hello, I’m ___________ with _____________, an independent marketing research firm. We are not selling any product or service. We are conducting a research study on behalf of the U.S. Department of Health and Human Services (HHS) and would like to include your views. The research is about electronic health records and other forms of health information technology. The session will not focus on any specific medical condition, but instead will focus on how health information technology can help people manage their health care and the health care of family, friends and others in their care. My questions will only take a few minutes. May I speak with (name)?
1. First, do you, or does any member of your household or immediate family, work for or is retired from:
A market research company _____
A direct mail company or direct marketing company _____
An advertising agency or public relations firm _____
[IF YES TO ANY >> TERMINATE]
2. Are you the mother of a child or children under age 18, who live(s) in your household?
Yes_____
[TERMINATE] No _____
3. Do you currently keep files of your child’s health records?
Yes_____
[TERMINATE] No _____
4. How comfortable are you in using the Internet to look for information about health topics or medical conditions?
Very comfortable _____
Somewhat comfortable _____
Not very comfortable _____
[TERMINATE] Not at all comfortable _____
5. Which of the following categories best describes your total annual household income? [ATTEMPT MIX]
Under $15,000 _____
$15,000 - $34,999 _____
$35,000 - $54,999 _____
$55,000 - $74,999 _____
$75,000 - $100,000 _____
Over $100,000 _____
6. Please tell me your age.
7. What is your current marital status? Are you ….. ?
Married or living with a partner_____
Single _____
Divorced _____
Widowed _____
8. What is the highest level of education you have completed? [ATTEMPT MIX]
Less than high school graduate _____
High school graduate _____
Some college _____
Post graduate studies or degree _____
9. So that we can be sure that all backgrounds are represented in our study, please tell me your ethnic or race background. Are you … ?
[ATTEMPT 2-3 MINORITIES]
Ethnicity
Hispanic or Latino_____
Not Hispanic or Latino_____
Race
American-Indian or Alaska Native _____
Asian _____
Black or African American _____
Native Hawaiian-Indian or Other Pacific Islander _____
White _____
Other _____
10. Have you ever attended a focus group discussion or individual interview? By that we mean an informal, round-table discussion, conducted by a professional moderator in which you were asked your opinions regarding a product, a service, or advertising?
MAX. ½ GROUP >> ASK A-B >> Yes _____
INVITE TO GROUP >> No _____
How many of these groups have you attended?
______________________________ [MAX. 4 EVER]
How long ago was the last one of these groups you attended?
______________________________ [MUST BE AT LEAST 6 MONTHS AGO]
[INVITE TO GROUP]
[INVITE TO GROUP]
Thank you for answering my questions. As I mentioned, we are conducting a study about electronic health records and health information technology on behalf of the U.S. Department of Health and Human Services. Your input is critical to the success of the project.
In order to accomplish our research objective, we would like to invite you to take part in an informal, group discussion to be conducted on [DATE] at 6:30 P.M. The discussion will be led by a professional moderator and will last 1.5 hours or less. We are confident that you will enjoy the exchange of information and will find it beneficial.
As a token of appreciation for sharing your views, you will receive a $100 cash incentive at the time of the discussion.
We can only invite a select number of participants to take part. Can we schedule your participation? Unfortunately, your child cannot attend this session.
[If yes, read…..]
If you need glasses for reading or watching TV, please bring them with you to the discussion.
[Record Group]
Group/Date/Time:
ID# _______________________________________________________________
NAME: _________________________________________________
ADDRESS: _________________________________________________
CITY: _________________________________________________
ZIP CODE: _________________________________________________
PHONE: (DAY) ( )___________________________________
(EVE) ( )___________________________________
(FAX) ( )___________________________________
(CELL) ( )____________________________________
(EMAIL) ___________________________________________
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | Interviewer: _______________ |
| Author | Terry Brisbane |
| File Modified | 0000-00-00 |
| File Created | 2021-01-30 |