Qualitative Research to Design Advertising to Encourage Quitting Among Adult Cigarette Smokers (General Populations) CTP

Generic Clearance for the Collection of Qualitative Data on Tobacco Products and Communications

Attachment C - Screener Contact Sheet

Qualitative Research to Design Advertising to Encourage Quitting Among Adult Cigarette Smokers (General Populations) CTP

OMB: 0910-0796

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OMB# 0910-0796

Exp. 07/31/2021




SCREENER CONTACT SHEET

(Completed by recruiter)


TITLE OF INFORMATION COLLECTION: Qualitative Research to Design Advertising to Encourage Quitting Among Adult Cigarette Smokers (General Population)



Respondent’s name: Email address:

___________________________________


ID: ________________________________


ZIP Code: Mobile phone:

___________________________________ _____________________________


___________________________________ Home phone:

_____________________________

___________________________________

Recruited for session number and session type: Recruiter:

___________________________________ _____________________________




















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File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorMaria Roditis
File Modified0000-00-00
File Created2021-01-13

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