Informed Consent - CATI

Appendix C2. CATI Informed Consent Statement.doc

Use of Smartphones to Collect Information about Health Behaviors: Feasibility Study

Informed Consent - CATI

OMB: 0920-0972

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CATI Informed Consent Statement



ask if cadlt=1 or 18<=age<=66

CONSENT. You are eligible to be interviewed. I have just a few more questions, but first let me tell you that you don’t have to give me your name, address, or other personal information that can identify you. You don’t have to answer any question you don’t want to, and you can end the interview at any time. The rest of the interview will take about five minutes, any information you give will be kept private to the extent permitted by law. If you have any questions about this survey, I can give you a telephone number for you to call to get more information.

if necessary: The combined results of the survey will help CDC make decisions about how to keep Americans healthy.

[Is respondent continuing with the interview?]

1. YES

2. NO / TERM/



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File Modified2013-04-17
File Created2012-05-16

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