Exhibit 5

Exhibit 5.docx

Survey of Eligible Users of the National Practitioner Databank

Exhibit 5

OMB: 0915-0366

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Exhibit 5. Initial Telephone Communication with Non-Users


May I speak to the Director of Medical Services?


The U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA) is conducting a national survey of its eligible users of the NPDB. In 2001 and 2008, HRSA conducted surveys of eligible users to ensure HRSA is meeting the needs of organizations such as yours. The results of the 2013 survey will be provided on the HRSA website; the evaluation will guide the future strategic directions of the NPDB, and we thank you in advance for your cooperation.


HRSA contracted with a small business, Cherry Tree Business and Statistical Consulting (Cherry Tree BSC) to conduct the survey. Information regarding this call is on the HRSA website, (…………enter here). As an eligible user of the NPDB, you have been selected to provide feedback on the survey which discusses licensure, credentialing, hiring or other types of activities for which the NPDB contents lends itself.

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 NIH (a maximum donation of $5,000 for all surveys).

The evaluation is conducted on a secure web-site. You can either provide me your email address so that you can immediately receive an email from HRSA, or you can send an email to the HRSA email box (…..) so that we may reply and forward you the invitation letter explaining the need for the survey, the confidentiality of the survey and a Question/Answer document regarding the survey. Once you receive the official invitation letter, you will be provided the web link to complete a short survey.


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]. Once again, thank you in advance for your cooperation with this request. Your responses will be confidential and used for research purposes.


Cherry Tree BSC, on behalf of the

Division of Practitioner Data Banks

of the Bureau of Health Professions,

Health Resources and Services Administration

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