WIC Child Retention (State Agencies) (1 of 2)

Appendix A.13. Post-Survey Response Clarification Email OMB Number: 0584-0613

Expiration Date: 02/28/2021

To: [EMAIL ADDRESS OF CLINIC-LEVEL STAFF MEMBER NAME]

Subject: USDA FNS WIC Child Retention Survey

Dear [CLINIC-LEVEL STAFF MEMBER NAME]:

Thank you for completing the WIC Child Retention Survey. In reviewing the survey data we have found we need further clarification on the following question(s) from your survey responses:

Question: [INSERT QUESTION]	Response: [INSERT RESPONSE]
Clarification: We would like to know . . .
Question: [INSERT QUESTION]	Response: [INSERT RESPONSE]
Clarification: We would like to know . . .

If you can provide this information, it would be very much appreciated. You may reply directly to this email at [email protected]. If you would like to provide your answers over the phone, please contact the Study Team directly at 1-877-440-0050 (toll-free) from 9:00 a.m. to 4:00 p.m. Eastern Time Monday through Friday. If you call outside of these hours, please leave a message, and we will return your call the following business day.

Thank you for your participation in this study.

Linda Piccinino

Project Director| 2M Research

This information is being collected to assist the Food and Nutrition Service in understanding why children ages 1 to 4 years leave the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). This is a voluntary collection and FNS will use the information to better understand Local Agency strategies related to improving child retention in the WIC Program. This collection does not request any personally identifiable information under the Privacy Act of 1974. 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 0584-0613. The time required to complete this information collection is estimated to average 0.08 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to U.S. Department of Agriculture, Food and Nutrition Service, Office of Policy Support, 1320 Braddock Place, Room 555, Alexandria, VA 22314 ATTN: PRA (0584-0613). Do not return the completed form to this address.