Pilot Survey

National Survey
of Prescription Drug Advertising

10903 New Hampshire Avenue
Silver Spring, MD 20993

Month XX, 2016

12345*********RTN RW3686***********FC

1234 Main Street
Rockville, MD 20850

Dear Rockville Resident,
Over the past few weeks I have sent you several mailings asking for your help with a national survey
about prescription drug advertising and health. The purpose is to understand about the types of
advertising you have seen on television, Internet, and magazines, and your opinions about the
information they contain.
This study is drawing to a close, but I would like to include your views as you may have different
experiences from those who have already taken part. Hearing from everyone chosen assures that
the survey results are as accurate as possible.
You can take part by completing the enclosed survey questionnaire. Please mail back the survey
in the pre-addressed return envelope. Postage has already been paid.
We can assure you that your individual privacy will be maintained in all published and written data
resulting from the study. The information will be combined for all participants and reported only as
statistical summaries. You will not be individually identified and your personal information will not
be shared unless required by law.
Your participation is voluntary, but we hope that you will fill out and return the questionnaire soon.
If you have any questions or comments about this study please call Westat, a research company
conducting this survey on behalf of the FDA, at 111-111-1111 or email [email protected].
Thank you for your help in this important research.

Helen Sullivan, PhD
Project Director, Food and Drug Administration

¿Prefiere completar a encuesta en español?
Por favor llame al xxx-xxx-xxxx.
OMB 111-1111

Exp. xx/xx/xxxx
C3 HH1