Individuals or Households Respondents

OMB Number: 0584-XXXX

Expiration Date: XX/XX/XXXX

Appendix G.5. Return Call to Schedule Survey in English

Hello. My name is [interviewer name], and I am calling about a study of health and well-being in Puerto Rico. May I please speak with [caller name]?

Thank you for your interest in taking this survey over the phone. Are you available to complete the survey now? It will take about 40 minutes.

If yes: Great, let’s get started [request verbal consent and review statements required by IRB/OMB].

If no: That’s ok. We can schedule another time for a data collector to call you. What day and time works for you? [schedule survey day/time]. Excellent. We will call you back at [time] on [day]. Thank you!

Public Burden Statement

This information is being collected to assist the Food and Nutrition Service (FNS) in understanding food security status and economic well-being among Puerto Rico residents. This is a voluntary collection. FNS will use the information as a baseline for future assessments of food security and the Nutrition Assistance Program, particularly in the context of natural disasters. This collection does not request personally identifiable information under the Privacy Act of 1974. According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0584-XXXX. The time required to read this information is estimated to average 3 minutes. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: U.S. Department of Agriculture, Food and Nutrition Service, Office of Policy Support, 1320 Braddock Place, Alexandria, VA 22314. ATTN: PRA (0584-XXXX). Do not return the completed form to this address.

Food Security Status and Well-Being of NAP Participants in Puerto Rico, Appendix G.5. Return Call to Schedule Survey in English Household G-1