Appendix C21 NAMES Appointment Reminder Letter

APPENDIX C21. NAMES APPOINTMENT REMINDER LETTER

OMB Number: 0584-XXXX

Expiration Date: XX/XX/XXXX

<DATE>

<PARTICIPANT FIRST NAME LAST NAME>

<STREET ADDRESS>

<CITY, STATE ZIP>

Dear <PARTICIPANT NAME>,

Thank you for agreeing to be part of the NAMES Study. We owe our success to your help.

A NAMES Study interviewer is scheduled to visit (your home, <PARTICIPANT ADDRESS</<CHOSEN LOCATION, ADDRESS> on <DATE AND TIME>. If you are not able to keep this appointment, please let us know as soon as possible.

A worksheet is enclosed so you can prepare for the interview. Please complete the worksheet before the appointment and have it with you during the interviewer’s visit. Details are included about acceptable documents to use as proof of your household’s income from paid work and/or benefit payments. We ask that you gather copies of the described income and benefit materials which document the income amounts for all adult household members. The interviewer will only look at the documents for the needed information and will not copy or keep your documents.

As a reminder, you can receive a thank you gift card of up to $50, once you finish the interview. The total amount depends on the tasks you do. You will get $30 for doing the interview and an additional $20 if you also have documents available to confirm your household’s income.

Please do not wait to call us at 1-855-272-0058 or email us at <NAMES EMAIL>if you have any questions or if your appointment needs to be changed. Thank you for your support!

Sincerely,

<SIGNATURE>

<NAME>

<TITLE>

Enclosures: NAMES Survey Income Worksheet

According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0584-XXXX. The time required to complete this information collection is estimated to average 5 minutes per response, including the time to review instructions, search existing data sources, gather and maintain the data needed, and complete and review the collection of information.