Document

Att3_5_ApptReminderCard_20131205

ICR 201312-0923-001 · OMB 0923-0049 · Object 43730801.

Document Viewer [docx]

Status: Original and derived artifacts are available for this document.

Download: docx | pdf | html

Primary: docxSource: application/vnd.openxmlformats-officedocument.wordprocessingml.document
Loading document viewer…

Document Metadata

Record metadata
application/vnd.openxmlformats-officedocument.wordprocessingml.document
Att3_5_ApptReminderCard_20131205
CDC User
Writer
2013-12-05
2026-09-28
complete

Extracted Text

Attachment 3.5
Anniston Community Health Survey: Follow-up Study and Dioxin Analyses
Appointment Reminder Card – CCHD (page 1 of 2)





Appointment Reminder Card – West Anniston (page 1 of 2)




















Appointment Reminder Card – Home Visit (page 1 of 2)




Appointment Reminder Card – Instructions (page 2 of 2)


Instructions
On the day of your appointment
Fasting:  Do not eat or drink for at least 8 hours before your appointment.  Do not have candy, gum, or soda. Drinking water is fine. Take all your medications with water only.
If you have diabetes and take insulin or other medications, we will schedule your appointment as early in the morning as possible. Please fast for at least 8 hours if your meal and medication plan allows. If you must eat before your appointment, please eat fat-free or low-fat items and take your medications as usual. Write down what you ate and when you ate it.
Medications: Please have all of your regular medications that you have taken for the past two weeks with you. Putting them in a plastic bag will make it easy. We want to know about:
    • Prescriptions
    • Over-the-counter medicines
    • Supplements and vitamins
    • Fish oil
    • Herbal remedies
    • If any of your medications need to be kept chilled, please leave them in your refrigerator. Make a note to tell us about them.
Questions: If you have any questions, please contact us at our toll-free phone number (855) 822-1778. Thank you for taking part in this study.