NPIN Initial Questionnaire Telephone Script

[NCHHSTP] Resources and Services Database of the National Prevention Information Network

Att 3A_NPIN Initial Questionnaire Phone Script with MpoxVaccineTesting

OMB: 0920-0255

Document [docx]
Download: docx | pdf

Form approved

OMB No.0920-0255

Exp. date: 01/30/2023








Resources and Services Database of the CDC National Prevention Information Network




Attachment 3A

NPIN Initial Questionnaire Telephone Script


















Public reporting burden of this collection of information is estimated to be 7 minutes per response, including searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor or respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA No. (0920-0255).













NPIN Initial Questionnaire Telephone Script

Form approved OMB No.0920-0255 Exp. date: 01/30/2023


Public reporting burden of this collection of information is estimated to be 7 minutes per response, including searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, or respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA No. (0920-0255).


Note: Use this script when calling an organization to be added to the NPIN Organization Database.

When calling organizations, you need to first identify yourself and the reason for your call.


Hello, my name is __________________________ and I’m calling your organization on behalf of Centers for Disease Control and Prevention’s (CDC) National Prevention Information Network. NPIN provides resources and services related to HIV/AIDS, viral hepatitis, STDs, and Tuberculosis. The mission of NPIN is to serve the information needs of State and local HIV/AIDS/Viral Hepatitis/STD/TB program personnel and other professionals. We are creating a new record for ___________________< insert organization’s primary name> and want to make sure the information we have collected is accurate. The information we collect in the NPIN database is used to update the NPIN and Get Tested Websites, and other sites like AIDS.gov. Your participation is voluntary.


Next, ask the receptionist or operator to verify the following:

  • Organization Name (including any department, division, or program)

    • Be sure to confirm the primary name.

  • Organization’s Corporate address or mailing Address including:

Street 1, Street 2 (PO Box, Suite), City, County, State, Zip Code,

  • Phone Number(s)

Main Phone, Fax Number, Toll Free Number, Other Numbers

Website

    • Ask if the information on the website is accurate and up to date.

    • Ask for a general email address

    • Ask for the email of staff contact person. It is important to get ask for an e-mail address for the staff contact(s) and inform the organization representative that going forward we will send an e-mail once a year to verify information.

  • Hours of Operation

  • Organization Type: Federally Qualified Health Center, Public Health Department, Clinic

If an operator is not available and you have the option, choose the appointment line. Often times, the appointment line will provide information about hours of operation, eligibility criteria, and fees.


Next, ask to speak to the HIV program director/coordinator, outreach staff OR the nursing supervisor to verify the following (when possible, gather this information from the website first):

  • Fees for services

    • Testing fees

    • Fees for other services

  • Appointment information

  • Eligibility restrictions

  • Services Offered (Check the services that apply)

SUPPORT SERVICES

Ryan White Services



PrEP Navigation



Case Management



Housing Opportunities for Persons with AIDS/HOPWA



Drug Purchasing Assistance (ADAP)


CAPACITY BUILDING

Research



Training Programs



Health Professional Education


PREVENTION SERVICES

Needle Cleaning, Needle Exchange or Needle distribution



TB Prevention/Education



STD Prevention/Education



HIV/AIDS Prevention/Education



Harm Reduction



Condom Distribution


TESTING SERVICES

Conventional HIV Testing



Rapid HIV Testing



HIV Self-Testing



Gonorrhea Testing



Chlamydia Testing



Syphilis Testing



Herpes Testing



STD Self-Testing



TB Testing



Hepatitis A Testing



Hepatitis B Testing



Hepatitis C Testing



Hepatitis Self-Testing



Mobile Testing Services



Mpox Testing



Self-Testing Distribution area:


TREATMENT SERVICES

Family Planning



TB Treatment



STD Treatment



HPV Vaccine



Pre-Exposure Prophylaxis (PrEP)



HIV/AIDS Medical Treatment



Post-Exposure Prophylaxis (PEP)



Hepatitis C Treatment



Hepatitis B Treatment



Hepatitis A Vaccine



Adult Hepatitis B Vaccine



Substance Abuse Treatment



Medication Adherence Education and Counseling



Mpox Vaccine



  • Audience Served

  • Language

  • Finally, thank the organization for helping with the collection of information.

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorGrettel Bustos-Galeano
File Modified0000-00-00
File Created2023-08-30

© 2024 OMB.report | Privacy Policy