Shared Decision Making

OMB No. 2900-0770
Estimated Burden: 10 minutes

Expiration Date: 08/31/2017

Phone Interview Contact Script: Veterans and family caregivers

Hello this is [Interviewer’s name] from the VA. May I speak with Mr. /Ms. (Veteran or family caregiver)?

I am calling to talk with you about the Shared Decision Making for Long Term Services and Supports project. Recently, you spoke with one of our Social Workers, about long term care options. Do you remember that experience?

• If yes, proceed below.

• If unclear if remember, give a brief description of the materials in folder to jog memory. If now yes, proceed below.

• If no, doesn’t remember, thank the person and terminate the call.

Did you have an opportunity to review the materials and talk with the social worker about long term care options?

• If no, thank the Veteran or caregiver and terminate the call.

• If yes, proceed below.

We’re asking people who reviewed this material and talked with their social worker about their long term care needs to give us some feedback on that experience. Can I ask you a few questions now? It will only take about 10 minutes.

• If yes, proceed below.

• If no, try to schedule another time that works for the Veteran/caregiver.

Before we start I’d like to give you a bit more information about this telephone interview.

Talking with me today is completely voluntary. No one will know whether or not you answer my questions. You can choose not to answer any specific question, and you can stop answering questions at any point. Anything you say will be kept confidential and your responses will not be linked to you in any report or in any other way.

Do you have any questions?

• If yes, answer questions.

• If no, go ahead with brief questionnaire.