Flyer to Hand to Patients

Patients Needed for a Survey - $25 Paid!!

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RTI International, a not-for-profit research organization, is seeking patients of this health center to participate in the Health Center Patient Survey conducted by the Health Resources and Services Administration.

We are looking for:

• Patients who received services at this health center in-person or through telehealth the past 12 months

• Male and female 18 years of age and over

• Parents of children 12 years of age and younger

• We are very interested in speaking with patients that primarily speak English [ADD LANGUAGES PATIENTS AT THE SITE SPEAK]

Participants will receive $25 gift card or check for a 60-minute phone interview.

All information provided will be kept private and not shared with the health center.

For more information and to determine eligibility, please call [FS NAME] at [FS phone number] by [DATE].

Please have this Record Number ready when you call: XXXXXXXX

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OMB Number: 0915-0368 Expiration date: 03/31/2023