B1 Consent

Attachment 1- B1 Applicant Consent Script.docx

Information Collection for Evaluation of Education, Communication, and Training Activities for Mobile Populations

B1 Consent

OMB: 0920-0932

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Attachment 1: B1 Applicant Consent Script



We are doing a project to improve awareness and knowledge of tuberculosis or TB and TB services in the United States for new immigrants. We are inviting you to do two short interviews today. You are being invited because your chest x-ray showed that you might have TB but your sputum tests [at SMF: your first two sputum tests] did not show TB germs. Each interview will take about 15 minutes. The first interview will happen now and the second interview will happen right after you receive education about TB and follow-up care in the United States. It is up to you if you want to do these interviews. You can choose to not answer any question and you can stop the interviews at any time. We will not collect your name or other personal information. Your decision to participate or not will not affect your medical care or your immigration process. There is little risk to you if you choose to join the project. Some questions are about TB and may make you feel uncomfortable. There is no direct benefit to you for joining the project. You will get the same education whether or not you decide to do the interviews. The information you share with us will help us improve TB education and services for new immigrants.

Do you have any questions before we begin?

Are you willing to join in this project?



File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorClements, Crystal (CDC/DDID/NCEZID/DGMQ)
File Modified0000-00-00
File Created2021-01-14

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