HEALTH DEPT. PHONE SCRIPT & CONSENT TO PROVIDE PATIENT NAME & PHONE NUMBER TO CDC
Hello. My name is [NAME]. I work at the [HEALTH DEPT NAME]. Recently you were contacted by our health department [Or, “we spoke recently”] because you tested positive for Zika virus.
I am calling you today because the Centers for Disease Control and Prevention (or CDC) is conducting a study of men who have been infected with Zika virus. Zika virus is usually spread by mosquitoes, but we now know that it can also be spread by men to their sexual partners. Because the virus has been linked to birth defects, this is a big concern for pregnant women or couples trying to get pregnant. The goal of CDC’s research is to find out how long the virus is found in the semen and urine of infected men. This information will help to better advise people on how to prevent sexual transmission of Zika virus and potentially prevent birth defects and other conditions linked to Zika virus.
Our records indicate that you are eligible for this study. We are contacting you to see if you may be interested in taking part. If you agree to take part, you will be asked to give samples of your urine and semen every 2 weeks for up to 6 months after your illness started. CDC will test your samples for Zika virus and give you the results at the end of the study. You will collect the samples at home and you will receive a token of appreciation for your time and effort.
We would like to know if it is OK to give CDC your name and telephone number so that they can contact you to tell you more about the study. You do not have to take part in the study. If you do enroll in the study, you may withdraw from the study at any time.
Can we provide your name and phone number to CDC so that they can contact you about this study?
YES_______ NO_______
[IF NO]: If you change your mind later, please call us at [PHONE #].
Do you have any other questions before we hang up?
Thank you for your time. Have a nice day!
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Hinckley, Alison F. (CDC/OID/NCEZID) |
| File Modified | 0000-00-00 |
| File Created | 2021-01-23 |