Att 13C_Dup Salt Sample Collection Instr (non Sub Study)_01082014

Form ______

OMB No. 0920-0982

Expiration date: 09/30/2015

Duplicate Salt Sample Collection Instructions for Participants (Non Sub Study)

Salt added to food at the table

Please provide duplicate samples whenever you add salt to your food at the table. This includes salt added to food at home and away from home. Shake the same amount of salt shaken onto your food into a bag with a neon label immediately following adding salt to your food on the table. If you forget to do this during the meal, do it as soon as possible afterward. Record the type of salt used (regular salt including sea salt, iodized salt, non-iodized salt, and kosher salt; or another type such as lite salt or salt substitute) on the bag label. You will use one neon-labeled bag per collection day for all your salt added to food at the table. If you do not add salt to your food at the table on your collection date, please check the box “I did not add salt at the table today”.

Salt added in preparing food at home

Please also provide duplicate samples of all salt added to your food in home cooking. Any salt added to food prepared outside your home does not need to be collected. Put the same amount of salt added to the dish in a bag with a white label immediately after adding salt to the dish. Record the date, name of the dish prepared and type of salt used (regular salt including sea salt, iodized salt, non-iodized salt, and kosher salt; or another type such as lite salt or salt substitute) on the bag label. Record the total amount of the dish you prepared on the ‘Food Record Form’. Each dish you add salt to in your home cooking will have a separate bag of duplicate salt so you may use multiple white-labeled bags for one collection day.

Sending salt to coordinating center

After you have completed your fourth telephone recall, please send your samples to the coordinating center in the preaddressed, postage paid, padded mailer you received at your initial clinic visit. Before mailing, please ensure that all the bags are tightly sealed and each label has been filled out completely. If you did not add salt at the table or use salt in home cooking, please return the empty bags to the coordinating center (the neon labeled bags should have the box checked noting that you did not add salt at the table on that day). We will begin processing your payment once we have received your duplicate samples. If the coordinating center has not received your duplicate salt samples within one week of the scheduled collection date you will receive a reminder call, email, or mailing depending on your communication preference.

If you have any questions please call the clinic manager at 612-462-7751.