Att 6 Intercept Receipt Form_reinstatement_07-14-20

Form Approved

OMB No: 0920-1169

Exp. Date: 03/31/2020

Development of CDC’s Let’s Stop HIV Together Social Marketing Campaign for Consumers

Attachment 6: Intercept Interview Receipt Form

Attachment 6: Intercept Interview Receipt Form

Let’s Stop HIV Together Project

I acknowledge receiving $20 as a token of appreciation for participating in an interview for the Let’s Stop HIV Together project conducted by RTI.

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Participant Initials Date

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Interviewer Signature Date