Letter Invitation for Web Survey

SAMPLE LEAD LETTER FOR FIRST WEB SURVEY INVITATION MAILING
Outpatient and Ambulatory Surgery CAHPS Survey
To be Printed on Ambulatory Surgery Center or Hospital Outpatient Department or Vendor
Letterhead
«FirstName» «LastName»
«Address1» «Address2»
«City_Name», «State_Code» «Zip_Zip4»
Dear «FirstName» «LastName»:
[FACILITY] would like to learn more about the quality of health care that their patients receive.
[VENDOR], an independent research company, is conducting this survey. We would like to
know about your experience visiting [FACILITY] on [DATE OF SURGERY].
Please take a few minutes to provide your feedback in this brief survey. The overall survey
results will be available online at https://www.medicare.gov/. These results help people choose
an outpatient or ambulatory surgery facility.
To begin the survey, you may type the website link provided below into the URL search bar at
the top of your web browser. You will be prompted to enter an access code (provided below) to
ensure privacy.
Survey: [WEB SURVEY URL]
Access Code: [UNIQUE ACCESS CODE]
All your answers will be confidential and are protected by a federal law called the Privacy Act.
Your answers will be grouped with answers from all other people who take the survey. Your
name and anything that might identify you will not be linked to your answers. Taking part in the
survey is voluntary and will not affect any health care benefits you receive.
If you have questions, please call [NAME] toll-free 1-800-XXX-XXXX or send an email to
[VENDOR EMAIL ADDRESS]. If you need help with reading the questions or marking your
answers, you may ask a friend or family member to help you. Si tiene preguntas o desea recibir
la versión de la encuesta en español, por favor llame al 1-800-XXX-XXXX o envíe un correo
electrónico a [VENDOR EMAIL ADDRESS].
Thank you, in advance, for taking this survey.
Sincerely,
[NAME]
[TITLE]

[PRINT UNIQUE SAMPLE ID NUMBER HERE]