Participant ID: _________
Phone Check-In
Document nature of all contact between subject and research team (indicate date/time for each event).
Phone Contact Date/Time ____ /____ /____ _____:_____
Contact RA: _____________
Did you have any truck breakdowns this month? __________________________________________________
Did you take any vacation days this month? ______________________________________________________
On how many duty days this week did you spend 10 or more consecutive hours of rest in your sleeper berth,
Did you wear the actigraph at all times (even while sleeping)? ___________________________________
Did anyone else drive your truck? __________________________________________________________
Did you have trouble with any of the study equipment this week? ________________________
Do you have any questions regarding the study or procedures? ________________________
Did anyone other than you use your smartphone, actigraph, or other study equipment? _________
If so, approximate date/time? _________________
When did you last sync and charge your actigraph? ________________________
When did you last charge your study smartphone? ________________________
Notes:____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Compliance issues noted by RA: _____________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Revised
12/1/2017 Page
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | Driver Type (circle): Large Carrier / Medium Carrier / Small Carrier / Owner Operator / Team Driver |
| Author | Sparrow, Amy |
| File Modified | 0000-00-00 |
| File Created | 2021-01-13 |