Att 11c_Model Patient Recruitment Script - Facility

Attachment 4c

Model Patient Recruitment Script-Facility

Medical Monitoring Project

0920-0740

Model Patient Recruitment Script

Provider/Facility Makes First Contact

Please use this Patient Recruitment Script to contact patients for participating in the Medical Monitoring Project after receiving a list of randomly selected patients from the Health Department.

Script

Name of patient you are calling____________________________________________

Hello my name is _______________________with [insert facility name]. I am calling to let you know about a project called [insert local project name], in collaboration with the Health Department and the Centers for Disease Control and Prevention (CDC) and [facility name if applicable].

I am asking for your voluntary participation in this health department project. Your experiences and opinions are really important for guiding care for HIV patients both here in [insert project area name] and around the country. Hearing from patients like you will help us serve you better.

If you agree to participate, you will be asked to complete a 45 minute in-person, videoconference, or telephone interview and allow your medical records to be abstracted. Medical record abstraction is a process where selected information from your medical record will be looked over and recorded onto a form. You will receive $____ as a token of appreciation. This survey is completely confidential. Neither your name nor any other information that identifies you will be recorded with the interview and medical record information we collect for this project.

A representative from the Health Department will contact you to set up an appointment for you to sign the consent form, complete the in-person interview, and receive your $____.

If you have any questions regarding [insert local project name], please call [insert phone number], and ask for [MMP Project Area staff contact].

I would like to thank you in advance for your participation in this very important activity that will positively impact health care and reduce illnesses among persons living with HIV/AIDS in [insert project area name].