Appendix B - Screener

Medical Conference Attendees’ Observations about Prescription Drug Promotion

Appendix B - Screener

OMB: 0910-0901

Document [docx]
Download: docx | pdf

FDA Conference Attendees Study

Eligibility Screener

Thank you for your interest in this study. Please answer the following questions to determine if you are eligible to participate.


S1. Are you currently authorized to prescribe medications to patients?

  1. Yes

  2. No

If no, skip to ineligibility statement.

S2. Did you attend, or are you currently attending, this year’s [CONFERENCE NAME] either in person or virtually?

  1. Yes – Attending in person

  2. Yes – Attending virtually

  3. No

If no, skip to ineligibility statement.

S3. What percentage of your professional time do you spend in direct patient care? Your best estimate is fine.

  1. 20% or higher

  2. Less than 20%

If less than 20%, skip to ineligibility statement.

S4. Do you work for any of the following organizations (not counting occasional consulting)?

  1. U.S. government

  2. Pharmaceutical company

  3. Biotechnology company

  4. None of the above

If federal government, pharmaceutical company, or biotechnology company are selected, skip to ineligibility statement.

S5. This survey will involve watching a video. Do you have any problems with your vision or hearing that would prevent you from seeing or hearing the video?

  1. Yes

  2. No

If yes, skip to ineligibility statement

Ineligibility statement: Thank you for completing these questions. You are not eligible for this study.

Research authorized by Section 1701(a)(4) of the Public Health Service Act (42 U.S.C. 300u(a)(4)). Confidentiality protected by 5 U.S.C. 552(a) and (b) and 21 CFR part 20.


File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorSullivan, Helen W
File Modified0000-00-00
File Created2021-08-23

© 2021 | Privacy Policy