Consent to share information script

Attachment 12. WPHSS_Phone scripts for states to share contact information.docx

Women's Preventive Health Services Survey

Consent to share information script

OMB: 0920-1200

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OMB #0920-xxxx

Exp. Date xx-xx-20xx


TELEPHONE SCRIPTS FOR STATES


INTRO1. Hi. May I speak with [NAME]?


YES – GO TO INTRO2.

NO – ASK IF THERE IS A BETTER TIME TO CALL BACK


INTRO2. This is [INTERVIEWER NAME] calling from [PROGRAM/STATE]. I won’t take too much of your time today. CDC and NORC at the University of Chicago are conducting a study on women’s health. They would like to send you information on the study. We are calling today to see if we can share your contact information. This does not mean you have to participate in the study. NORC will contact you in the future with details about the study. Again, right now, we are calling to see if you would be willing to share your contact information – would you agree?

YES – GO TO CONTACT

NO – ASK IF THERE IS A REASON WHY, IF STILL REFUSE THANK AND HANG UP


CONTACT. Great, thank you! Can you confirm your current mailing address?


ADDRESS1. ___________________________________________


ADDRESS2. ___________________________________________


CITY ___________________ STATE___________ ZIP _____________


PHONE. Is the best number to reach you at, or is there a better phone number?


PHONE NUMBER _(_____)______-____________


THANK. Thank you for your time today!


File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorStephanie Poland
File Modified0000-00-00
File Created2021-01-22

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