Exhibit 4

Exhibit 4. Initial Sample Letter to Respondents, sent via Email

Subject line: The National Practitioner Data Bank Would Like Your Opinion on Self-Query

Dear _____________,

The U.S. Department of Health and Human Services, Health Resources and Services Administration is conducting a national survey of its eligible users of the National Practitioner Data Bank (NPDB). We periodically conduct these surveys to ensure that we are meeting the needs of those who use the NPDB. As a self-querier, you have been selected to provide feedback on the NPDB products and services.

Your opinions matter to us!

The survey will take approximately 10 minutes to complete. Your responses will be confidential and used for research purposes only. The survey results will help NPDB identify areas for improvement and help to guide the future strategic decisions of the NPDB.

To complete this survey on our secure website, please click on this link https://www.research.net/s.aspx?sm=bSFCCcMhJVAkM9Hy_2fyY6TA_3d_3d.

Support donations to the Children’s Inn

We have contracted with a small business, Cherry Tree Business and Statistical Consulting (Cherry Tree BSC) to conduct this survey. In recognition of your valuable time and critical feedback, Cherry Tree BSC will donate $1 for each completed survey to the Children's Inn, a non-profit providing a home-like environment for children receiving medical treatment at the National Institutes of Health (NIH). A maximum of $5,000 will be donated.

If you have questions concerning any aspect of the survey, including confidentiality, please feel free to call Cherry Tree BSC at 423-433-7728 or email at [email protected].

Thank you in advance for your help and cooperation with this request.

Sincerely,

Harnam Singh, PhD.

Research Branch Chief

Division of Practitioner Data Banks

of the Bureau of Health Professions,

Health Resources and Services Administration

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