Interviewer Recruitment Script final_Phone_version

OMB# 0915-0368
Expiration Date 03/31/2023

Health Center Patient Survey

Interviewer Recruitment Script

INTRODUCTION

Hello my name is: YOUR NAME and I work for RTI International, a not-for-profit research firm located in Raleigh/Durham North Carolina.

I am working with: NAME OF CLINIC to conduct a patient survey sponsored by the Health Resources and Services Administration.

The survey will try to find out what kinds of health problems people come to health centers with and how well the health centers are meeting the needs of the people who use them.

This survey will be done [face-to-face/over the telephone] and will take approximately:

ADULT INTERVIEW: 60 minutes

ADOLESCENT INTERVIEW: 50 minutes

CHILD-PROXY INTERVIEW: 45 minutes

and we will provide {INSERT TYPE OF INCENTIVE} as a token of appreciation for participating. The survey is voluntary and all information that you tell me will be kept completely confidential.

I would first like to ask you a few questions to determine whether you are eligible to participate.

IF NOT ON THE PHONE OR IN PRIVATE LOCATION: If you will follow me, we can go to a private location to ask you the eligibility questions.