MEC Examination Materials

Attachment 11e
MEC Examination Materials

A. MEC Appointment Slip ...................................................................................................... 11e-2
B. MEC Reminder Letter ......................................................................................................... 11e-4
C. MEC Examination Text and Email Communications ........................................................ 11e-8
D. Lab Blood Flyer ............................................................................................................... 11e-11
E. Community Service Letter ................................................................................................ 11e-15
F. School Excuse Letter ........................................................................................................ 11e-16

11e-1

11e-A
2025 Appointment Slip

The Nation’s Mobile Health Survey

Don't miss out on your
free NHANES health exam!
Appointment Details:
Name:
Date:
Time:
Location:
Transportation Funds:
If you provided a cell phone number
and gave us permission, we will send
you a reminder text the day before your
exam appointment.
Professional
Interviewer:
If you have any questions or need to reschedule
your appointment, please call 800-344-1386.

11e-2

Instructions for the Day of Your Appointment
Thank you for following these instructions to make sure
your time in the Mobile Exam Center is easy and your
results are accurate.
1. Do not eat or drink anything except
water after:
_____:_____
AM

•
•
•

•

NA

PM

Do not drink coffee, tea, soda, alcohol, or any other
beverage except water.
Do not chew gum, use breath mints, lozenges, cough drops,
or other cough or cold remedies.
Do not take non-prescription antacids, laxatives, antidiarrheals, or dietary supplements (such as vitamins or
minerals) before your exam.
If you eat or drink before the exam your test results may
not be accurate.

2. Take your prescription medications as directed
by your medical provider.
•
•
•

If it is ok with your doctor, do not take your diabetes pills
or insulin before your exam.
Bring them with you to take after your blood test.
You may bring food from home with you to eat right after
your blood test.

3. There will be a private area for you to change
into a shirt and pants specifically for the exam.
•
•
•

To make this easier consider wearing clothes that are easy
to change into and out of.
Please leave your jewelry at home so you do not need to
remove it for your exam.
You may want to bring a sweater or jacket to wear on top
if you get cold.

Our professional staff will be available to answer any
questions you may have during your exam.
26 MECApptSlip-V1

11e-3

11e-B

{DATE}

{ADDRESSEE NAME}
{STREET MAILING ADDRESS}
{CITY, STATE ZIP}

Dear {SP FIRST NAME/PARENT OR GUARDIAN OF SP FIRST NAME}:
Thank you for scheduling {your/{SP NAME}’s} free health exam at our Mobile Exam Center! This is
a reminder of {your/{SP NAME}’s} upcoming appointment. You can be proud knowing the results of
{your/{SP NAME}’s} exam will help you, your family, and your community now and in the future!

NHANES Appointment
{MEC APPOINTMENT DAY}, {MEC APPOINTMENT DATE}
{MEC APPOINTMENT TIME}
{MEC ADDRESS}

For your convenience, we are enclosing directions to the Mobile Exam Center.
All results from your {BLANK/child’s} free exam will be available in about 3 to 4 months. To further
thank you for your time, {you/{SP NAME}} will receive {MEC INCENTIVE} at the end of the exam. {You
have already been paid for your transportation costs on your electronic gift card.}
Let me again assure you that everything we learn from your {BLANK/child’s} exam will be kept
confidential.
Please do not hesitate to call 800-344-1386 if you have any questions. Thank you again for your time
taking part in this important health survey.
Sincerely yours,
{FS NAME}
Field Supervisor

407

{LETTER CONTROL ID}

11e-4

{MEC FASTING INSTRUCTIONS}

Instructions for the Day of Your Appointment
Thank you for following these instructions to make sure
your time in the Mobile Exam Center is easy and your
results are accurate:
1. Do not eat or drink anything except water after:
{MEC FASTING TIME}
{MEC FASTING DATE}
• Do not drink coffee, tea, soda, alcohol, or any other beverage except water.
• Do not chew gum, use breath mints, lozenges, cough drops, or other cough or
cold remedies.
• Do not take non-prescription antacids, laxatives, anti-diarrheals, or dietary
supplements (such as vitamins or minerals) before your exam.
• If you eat or drink before the exam your test results may not be accurate.

2. Take your prescription medications as directed by your
medical provider UNLESS they are required to be taken
with food.
• If it is okay with your doctor, do not take your diabetes pills or insulin before your exam.
- Bring them with you to take after your blood test.
- You may bring food from home with you to eat right after your blood test.

3. There will be a private area for you to change into a shirt
and pants specifically for the exam.
• To make this easier consider wearing clothes that are easy to change into and out of.
• Please leave your jewelry at home so you do not need to remove it for exams.
• You may want to bring a sweater or jacket to wear on top if you get cold.

Our professional staff will be available to answer any questions
you may have during your exam.
If you have any questions, please call 800-344-1386.
11e-5

{MEC SP 0-11 NO FASTING INSTRUCTIONS}

Instructions for the Day of Your Appointment
Thank you for following these instructions to make sure
your time in the Mobile Exam Center is easy and your
results are accurate:
1. Since {SP FIRST NAME} is younger than 12 years old, no
fasting is required for the exam.
• Your child may eat or drink as they normally would.
• Your child should take prescriptions, vitamins, supplements, and non-prescription
medicines as they normally would.

2. Before the exam, your child will be asked to change into
a shirt and pants specifically for the exams in a private
area.
• To make this easier, please dress your child in clothes that are easy to change into
and out of.
• Please leave your child’s jewelry at home so they do not need to remove it for the exam.
• You may want to bring a sweater, jacket, or small blanket if your child gets cold easily.

3. Special note for parents of children 3 to 5 years old:
• When your child comes in for their exam, we will collect a urine sample to test for
environmental chemicals that can be found in urine.
• DO NOT BRING A URINE SAMPLE WITH YOU. It will be collected during the
exam.
- We will ask that you assist your child to collect this urine sample at the exam
center’s bathroom.
- Having your child drink something before coming to their exam may make it
easier for them to provide a sample.
- Any drink you would like to give your child is fine.
- Food or drinks will not interfere with your child’s laboratory tests.

Our professional staff will be available to answer any questions
you may have during your exam.
If you have any questions, please call 800-344-1386.
11e-6

{MEC 12+ NO FASTING INSTRUCTIONS}

Instructions for the Day of Your Appointment
Thank you for following these instructions to make sure
your time in the Mobile Exam Center is easy and your
results are accurate:
1. No fasting is required for the exam.
• Because your exam is at {MEC APPOINTMENT TIME}, you do not have to fast.
• Food or drinks will not interfere with your laboratory tests.

2. Take your prescription medications as directed by your
medical provider.
• You may also take your non-prescription vitamins and supplements as you
normally would.

3. There will be a private area for you to change into a shirt
and pants specifically for the exam.
• To make this easier, consider wearing clothes that are easy to change into and out of.
• Please leave your jewelry at home so you do not need to remove it for the exam.
• You may want to bring a sweater or jacket to wear on top if you get cold.

Our professional staff will be available to answer any questions
you may have during your exam.
If you have any questions, please call 800-344-1386.
11e-7

11e-C
MEC Examination Text and Email Communications
MEC Examination Text and Email Messages
MEC Examination Appointment Text Message Reminder
Reminder: (Your/[SP NAME]’s) health exam for a U.S. Department of Health and Human Services
national health survey is on [date] at [time]. For appointment instructions and directions to the Mobile
Exam Center, please review the mailed appointment reminder letter or the appointment slip you received
when you were interviewed. For questions or to reschedule the appointment, please call X-XXX-XXXXXXX toll-free.
MEC Examination Appointment Email Reminder
Subject line: Reminder: Health exam for a national health survey
Dear ([SP NAME]/Parent or Guardian of [SP NAME]),
This is a reminder that (your/[SP NAME]’s) health exam is scheduled for [DAY], [DATE] at [TIME] at
[MEC LOCATION]. Please review the appointment reminder letter you received in the mail or the
appointment slip you received when you were interviewed in your home so that you can review the
instructions and the directions to the Mobile Exam Center.
(IF SP IS 12+ WITH A MORNING APPOINTMENT, DISPLAY: Please remember not to eat or drink
anything except water for 8 hours prior to your appointment.)
If you have any questions or need to reschedule the appointment, call X-XXX-XXX-XXXX toll-free. For
more information, you can go to https://myhealthsurveyportal.cdc.gov/. Thank you.
Sincerely yours,
(FS NAME)
Field Supervisor
MEC Examination Missed Appointment Text Message
Reminder: You missed (your/[SP NAME]’s) free health exam appointment for a U.S. Department of
Health and Human Services national health survey. (You/[SP NAME]) will receive ($MEC Incentive) for
completing your exam. To reschedule the appointment or if you have questions about the exam, please
call us toll-free at X-XXX-XXX-XXXX. Data from participants like you help to improve the health of
everyone in the U.S.!
Participant Portal Account Setup Text and Email Messages
Account Setup Text Message:
It is time to create your secure My Health Survey Portal account to access your exam results when
they are ready! Go to myhealthsurveyportal.cdc.gov and create your account today. Questions? Call
800-344-1386.

11e-8

Account Setup Email Message:
Subject: Create a My Health Survey Portal account
Hello,
It is time to create your secure My Health Survey Portal account to access your exam results when
they are ready! Go to myhealthsurveyportal.cdc.gov today and use the code our staff gave you to
create your account.
If you have any questions, please contact us at 800-344-1386,
Monday through Thursday: 9:00 am –11:00 pm
Friday: 9:00 am – 9:00 pm
Saturday: 9:30 am–6:00 pm
Sunday: 1:00 pm–9:30 pm Eastern Time.
Thank you,
My Health Survey Portal Team
Participant Portal Validation Code Communications
Validation Code Text Message:
Your My Health Survey Portal verification code is {6 Digit Validation Code}. Enter it at
myhealthsurveyportal.cdc.gov to verify your account. Questions? Call 800-344-1386.
Validation Code Email Message:
Subject: My Health Survey Portal Verification
Hello,
Your My Health Survey Portal verification code is {6 Digit Validation Code}. Enter it at
myhealthsurveyportal.cdc.gov to verify your account.
If you have any questions, please contact us at 800-344-1386,
Monday through Thursday: 9:00 am –11:00 pm
Friday: 9:00 am – 9:00 pm
Saturday: 9:30 am–6:00 pm
Sunday: 1:00 pm–9:30 pm Eastern Time
Thank you,
My Health Survey Portal Team
Participant Portal – Notifications of Early Results Text and Email Messages
Early Results Text Message:
There is a new exam result for {SP FIRST NAME} in the My Health Survey Portal. Please
log in at myhealthsurveyportal.cdc.gov to view the message. Questions? Call 800-344-1386.

11e-9

Early Results Email Message:
Subject: My Health Survey Portal New Message
Hello,
There is a new exam result for {SP FIRST NAME} in the My Health Survey Portal. Please log in at
myhealthsurveyportal.cdc.gov to view the message.
If you have any questions about accessing this message, call us toll-free at 800-344-1386,
Monday through Thursday: 9:00 am –11:00 pm
Friday: 9:00 am – 9:00 pm
Saturday: 9:30 am–6:00 pm
Sunday: 1:00 pm–9:30 pm Eastern Time
Thank you,
My Health Survey Portal Team
Participant Portal – Notifications of Final ROF Text and Email Messages
Final ROF Text Message:
Final results for {SP FIRST NAME} are available in the My Health Survey Portal. Please log in at
myhealthsurveyportal.cdc.gov to see the report. Questions? Call 800-344-1386.
Final ROF Email Message:
Subject: My Health Survey Portal Final Results Hello,
Final results for {SP FIRST NAME} are available in the My Health Survey Portal. Please log in at
myhealthsurveyportal.cdc.gov to see the report.
If you have any questions about accessing the results, call us toll-free at 800-344-1386.
Monday through Thursday: 9:00 am –11:00 pm
Friday: 9:00 am – 9:00 pm
Saturday: 9:30 am–6:00 pm
Sunday: 1:00 pm–9:30 pm Eastern Time
Thank you,
My Health Survey Portal Team

11e-10

11e-D

Laboratory Tests on Blood
Below are brief descriptions of some lab tests you may have as part of the health exam. The specific tests done
are based on the participant’s age and gender. Some of the NHANES exams and tests are usually done with
people who have specific health problems. Your results may show something abnormal but do not represent an
illness. If you take your results to your health care provider, they may recommend other tests that may or may
not identify health a concern. You will be responsible for any costs associated with these additional tests.

Allergy Testing
Allergies are caused by the immune system reacting
to substances that are usually harmless. High levels of
antibodies (IgE) indicate an allergy to a substance. The blood
test will check for allergies to very common substances.
Total IgE
Alpha-gal
Alternaria alternata (mold)
Ambrosia artemisilfolia (ragwood short/common)
Aspergillus fumigatus (mold)
Bermuda grass
Birch
Cat epithelium and dander
Cladosporium herbarum
Common ragweed
Cow’s milk
D. farina (dust mite)
D. pteronyssinus (dust mite)
Dog dander
Egg
Blatella Germanica (German cockroach)
Mouse urine proteins
Peanuts
Penicillium
Russian thistle
Shellfish (shrimp)
White oak

Cholesterol and Lipid Tests
The body needs cholesterol and other lipids. But if there is
too much, they can build up in the vessels, blocking blood
flow causing heart disease and stroke. High cholesterol is
a major risk factor for heart attack and stroke. These tests
measure the different types of cholesterol and lipids.
Calculated Low Density Lipoprotein (LDL): The “bad”
cholesterol that easily clings to blood vessels and causes
fatty blockages.
Cholesterol: Cholesterol is important to build cells. But if
there is too much in the blood it can cling to blood vessels
and cause fatty blockages.

High Density Lipoprotein (HDL): The “good” cholesterol
that helps remove “bad” cholesterol to prevent fatty
buildup in blood vessels.
Triglycerides (TG): Triglycerides are the substances that
the body makes to store energy. If the body has too much
triglycerides, it is stored in the tissue as fat. Too much fat
leads to many health issues including diabetes and heart
disease. High triglycerides are a major risk factor for heart
attack and stroke.

Complete Blood Count (CBC) Tests
A CBC provides details about the components of blood.
Red Blood Count (RBC): RBCs provide oxygen to the
body’s organs and allow them to function.
Hematocrit (Hct): The percentage of blood that is
made up of RBCs.
Hemoglobin (Hgb): The molecule in RBCs that carries
oxygen.
Mean Corpuscular Volume (MCV): The average size
of RBCs.
Mean Corpuscular Hemoglobin (MCH): The average
amount of Hgb in each RBC.
Mean Corpuscular Hemoglobin Concentration
(MCHC): The average concentration of Hgb in a group
of RBCs.
Nucleated Red Blood Cells (NRBC): The number of
immature RBCs. Normally NRBC are found in newborns
but it is concerning if found in older people.
Relative Distribution Width (RDW): The average size
of all RBCs. RBCs that are too small or too large may
be concerning.
Platelets: Blood cells that are used in clotting.
White Blood Count (WBC): WBCs fight infections using
different types of cells as listed below. This test measures
the amount of all WBCs in blood together. Each type listed
below is also measured as a total amount (absolute) and
its percentage of all WBCs.

Version: 5-30-2024
11e-11

Lymphocytes: WBCs that fight viral infections.
Neutrophils: WBCs that fight bacterial infections.
Basophils: WBCs that are involved in blood clotting
and reactions to allergies and parasites.
Eosinophils: WBCs that are involved in allergy
reactions.
Monocytes: WBCs that can create macrophages,
which engulf bacteria and viruses.

Nickel: Nickel comes from oil refineries and coal-fired
power plants. It also comes from cigarette smoke and
e-cigarettes. At very high levels, it can cause stomach,
lung, kidney, and liver problems, and may have a negative
effect on pregnancy.
Selenium: Elevated levels can cause hair loss, brittle
nails, and nervous system problems. Ongoing exposure
can cause difficulty breathing, tremors, kidney failure, and
heart failure.

Diabetes Tests

General Body Chemistries and Other Tests

Diabetes is a condition in which there is too much sugar
(known as glucose) in the blood. Excessive glucose can
cause damage to blood vessels and organs.
This test measures how much glucose is in the blood.
Although glucose is needed in the blood to provide energy
to the body’s organs and function, too much can cause
damage.
Glucose: A specific type of sugar in blood that is needed
to provide energy for the body’s organs and functions.
Hemoglobin A1C: Gives information about the average
blood glucose level during the past 2 to 3 months. It shows
how well glucose levels have been controlled for those
with diabetes.

Environmental Exposure Profile
These substances are naturally found at low levels in water,
soil, and food. The body needs some of these substances
to function, but they can cause health problems at higher
levels.
Arsenic: High levels can cause skin, kidney, and lung
cancer. Continued exposure can cause skin sores,
persistent numbness in hands and feet, and anemia.
Butyrylcholinesterase activity: Used as a marker for
pesticide exposure. Having a low level can also cause an
adverse reaction when given anesthesia (succinylcholine);
the reaction can cause paralysis and difficulty breathing.
Cadmium: This is found in tobacco and secondhand
smoke. High levels can cause cancer.
Chromium: Elevated levels come from factories and
burning of natural gas, oil, or coal. It is also found in
cigarette smoke. Exposure to high levels can be through
air, soil, or water and secondhand smoke. At very high
levels, it can cause kidney and liver damage and lung
cancer.
Lead: High levels can cause brain damage and learning
problems, especially in children.
Manganese: High levels come from exposure to
contaminated air or water and can cause brain damage.
Mercury: Mercury exposure can occur through breathing
it in, touching it, or eating fish or vegetables that come
from places where there is a lot of mercury in the water or
soil. It can cause kidney, brain, and stomach problems.
Mercury can be found in different forms that affect how
dangerous it is.

Version: 5-30-2024

There are many important chemicals that need to be in a
“normal range” for the body to function well. If the levels of
the chemicals listed below are too high or too low, it can
strongly impact one’s health.
Albumin: A specific type of protein in blood. Its level can
indicate how well the kidneys and liver are functioning.
Bicarbonate: A chemical in blood that indicates how well
the lungs are functioning.
Calcium (Ca): A mineral found mostly in the bones and
teeth. It is important for muscle and nerve function and
blood clotting.
Chloride (CI): One of the key chemicals that keep all the
other chemicals in balance.
Magnesium: A nutrient that regulates many important
body functions, such as blood pressure, glucose levels,
and muscle and nerve function.
Potassium (K): A nutrient found in your body’s cells.
Potassium is very important for muscle and nerve function.
Protein: The major building block of all cells. It is also key
to the function of cells.
Sodium (Na): The other key chemical that keeps all the
other chemicals in balance.

General Body Chemistries and Other Tests
These are nutrients are needed for the body to “process”
what is needs from the food for the body to function.
Vitamin B1: (Thiamine) and Vitamin B2 (Riboflavin)
nutrient that help the body release energy from food and
keep the nervous system healthy.
Vitamin B6: Nutrient that helps the body use and store
energy from food and is important in the function of RBCs
and moving oxygen to cells.
Vitamin B12: Nutrient that helps the body use and store
energy from food, keeps the nervous system healthy and
helps body use folate for RBCs.
Vitamin D: Nutrient that helps form and maintain strong
bones, healthy immune system and controls cell growth.
It is in food and can be made in the skin when exposed to
sunlight.
Methylmalonic acid (MMA): a chemical that is used to
measure availability of Vitamin B12.

11e-12

Hemoglobin Variants

Iron Profile

Hemoglobin holds oxygen in the RBC as it carries it to the
cells through the body. When there is not enough oxygen
going to the cell, it is called anemia. Most people over 1
year of age have Adult hemoglobin (Hb A), which is best at
carrying oxygen. Some people have different hemoglobin
(variant) that does not hold oxygen as well. This reduces
the RBC’s ability to carry oxygen, causing anemia. In most
cases, if there is only one variant, only mild anemia may
occur. But if there are two variants the anemia can be
much worse.
Hemoglobin B (Hb B): If it occurs with Hb S, it can cause
symptoms like those of sickle cell trait (SCT).
Hemoglobin C (Hb C): If it occurs with Hb S, it can cause
symptoms like those of sickle cell disease (SCD).
Hemoglobin D (Hb D): If it occurs with Hb S (hemoglobin
SD disease), it can cause more severe symptoms and
anemia.
Hemoglobin E (Hb E): Common variant associated with
a specific type of anemia called thalassemia. If it is found
with other variants, it can cause significant anemia.
Hemoglobin F (Hb F): If detected in people over 1 year
of age, it may it can indicate that other variants are also
present. However, having Hb F can reduce the severity of
anemia caused by other variants.
Hemoglobin S (Hb S): The hemoglobin associated with
SCD, which causes RBC to become bent, making it harder
to carry oxygen. If it occurs with HbA, it can cause SCT.

Iron is essential to the ability of RBC to carry oxygen. It is
also needed to make other important proteins and enzymes
needed by the body. Too little iron can cause anemia. Too
much iron can cause damage to organs. The tests below
measure substances that work with iron and are important
to RBC’s ability to carry oxygen.
Ferritin: A protein found inside cells that stores iron to be
used later. This test measures the amount of iron stored in
the body.
Folate (in RBC): A substance that is important in making
RBCs and genetic material found in every cell. This test
measures the amount of folate stored in the body.
Folate (in serum): This test measures recent folate
intake.
Iron: The amount of iron in the body.

Hepatitis Tests
These are viruses that infect the liver and can cause
damage over time if not treated. If there is an active
infection, the virus can be transmitted to others.
Hepatitis B Surface Antigen (HBsAg): A positive test
means active HBV infection that can be causing damage
to the liver. An HBV DNA test can tell how much virus
is present and is a good way to monitor if treatment is
working.
Hepatitis C Antibody (HCV Ab): A positive test indicates
current or past infection with HCV. Even after HCV is
treated and cured (i.e., the virus is gone), these antibodies
will remain.
Hepatitis C (HCV) RNA and Genotype: Indicates how
much and what type of HCV virus is present. If HCV has
been cured, HCV RNA will be “undetected.
Hepatitis D Antibodies and Antigens (Anti-HD/
HDAg): A liver infection that only occurs in those who are
also infected with the hepatitis B virus. (HBsAg Positive).
If positive, there is a co-infection which can cause more
damage to the liver.

Kidney Function Tests
The tests below measure substances that are affected by
the kidneys and can indicate how well they are working.
Blood Urea Nitrogen (BUN): A normal waste product
of the body that the kidneys filter out of the blood and
into the urine. A high BUN level may indicate poor kidney
function.
Creatinine: A normal waste product of the body that
the kidneys filter out of the blood and into the urine. If
creatinine is high, it may indicate poor kidney function.
Cystatin C: This level indicates how well the kidneys are
working. A low value indicates better kidney function.
Estimated Glomerular Filtration Rate (eGFR): Based
on other blood tests, an estimation of how well kidneys are
working to filter blood. A higher number indicates better
kidney function.
Uric Acid: A normal waste product that is filtered out of
the blood and into the urine. Too much uric acid can turn
into crystals and settle in bones, causing gout and kidney
disease. A higher level can indicate decreased kidney
function.
Urine albumin creatinine ratio (ACR): Based on other
urine tests, an estimation of how well kidneys are working
to filter blood. A lower number indicates better kidney
function.

Version: 5-30-2024
11e-13

Liver Function Tests

Reproductive Hormone Panel

The liver performs many essential functions for the whole
body by filtering blood. Increases in certain enzymes or
chemicals can indicate poor liver function. The tests below
measure substances that indicate how well the liver is
functioning. If their level is elevated it may indicate an issue
with the liver.
Alanine Aminotransferase (ALT): An enzyme found
mostly in the liver, which is involved in the breakdown of
body chemicals.
Alkaline Phosphatase: An enzyme found in the blood
that comes from liver and bone cells and is processed by
the liver.
Aspartate Aminotransferase (AST): An enzyme found
in many organs, which is involved in the breakdown of
body chemicals and is processed by the liver.
Bilirubin: A chemical made when hemoglobin breaks
down and is processed by the liver. It is then passed
through the kidneys and gives urine its yellow color.

These hormones help regulate the reproductive system
and sexual development. Levels that are too high or too
low can impact overall well-being. The levels vary between
male and females and by age.
17α-Hydroxyprogesterone (17-OHP)
Androstenedione
Anti-Mullerian hormone (AMH)—females only
Dehydroepiandrosterone sulfate (DHEAS)
Estradiol
Estrone
Estrone sulfate
Follicle stimulating hormone (FSH)
Luteinizing hormone (LH)
Progesterone
Steroid Hormone Binding Globulin (SHBG)
Testosterone

Gamma-Glutamyl Transferase (GGT): An enzyme
mostly found in the liver that helps move other important
chemicals around the body.
Lactate Dehydrogenase (LDH): An enzyme found in the
heart, liver, kidneys, blood cells, and lungs which the liver
is to process.

Thyroid Function Tests

Nutritional Biochemistries
These nutrients are necessary for the body to process what
it needs from food.
Methylmalonic acid (MMA): A chemical that is used to
measure availability of Vitamin B12 (see below).
Vitamin B1 (Thiamine) and Vitamin B2 (Riboflavin):
Nutrients that help the body release energy from food and
keep the nervous system healthy.
Vitamin B6: Nutrient that helps the body use and store
energy from food and is important in the function of RBCs
and moving oxygen to cells.
Vitamin B12: Nutrient that helps the body use and store
energy from food, keeps the nervous system healthy, and
helps the body use folate to build RBCs.
Vitamin D: A nutrient that helps form and maintain strong
bones and a healthy immune system and controls cell
growth. It is in food and can be made in the skin when
exposed to sunlight.

The thyroid is a small gland in the front of the neck. It
makes hormones that control many of the body’s most
important functions. Levels that are too high or too low
can impact overall well-being. These tests tell how well the
thyroid is working.
Thyroid Peroxidase (TPO): An enzyme found in the
thyroid gland that plays an important role in the production
of other thyroid hormones.
Thyroid Stimulating Hormone (TSH): A hormone
produced by the brain’s pituitary gland that controls how
much thyroid hormone is made by the thyroid gland.
Thyroid Stimulating Hormone Receptor Antibodies
(TRAb): The level of these antibodies is used to determine
if an overactive thyroid is caused by the body’s own
production of antibodies against the thyroid (Graves’
disease).
Thyroglobulin Antibodies: Antibodies made by the body
in response to thyroglobulin.
Total Triiodothyronine (Total T3) and Total/Free
Thyroxine (Free T4/Total T4): Hormones made by the
thyroid gland that regulate body temperature and the
metabolism of protein, fat, and carbohydrates.

Version: 5-30-2024
11e-14

11e-E

{DATE}
NAME: {SP FIRST NAME} {SP LAST NAME}
To whom it may concern:
The person named above has taken part in an important national health study.
This study is a federal program authorized by the Public Health Service Act and conducted
by the National Center for Health Statistics, part of the Centers for Disease Control and
Prevention.
{SP FIRST NAME} {SP LAST NAME} participated in this study. They are among the many
people in towns and cities across the country who helped us increase our knowledge about
the health of the people in the United States. Their contribution to this study entitles {SP
FIRST NAME} {SP LAST NAME} to five hours of community service credit. Their participation
was absolutely essential to the success of the study and was greatly appreciated.
Please feel free to use this letter as verification of hours served. If you need further
verification, please call {SUPPORT PHONE}.
Sincerely,

Alan E. Simon, MD
Division Director
National Center for Health Statistics
Centers for Disease Control and Prevention

{LETTER CONTROL ID}

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11e-F

{DATE}
Dear Principal:
Please excuse the below named student from class for their participation in an important
national health study conducted by the Centers for Disease Control and Prevention. The date
of the student’s appointment is indicated below.
NAME: {SP NAME}
APPOINTMENT DATE: {MEC APPOINTMENT DAY}, {MEC APPOINTMENT DATE}
Thank you for your cooperation and your appreciation of the valuable contribution this student
is making to our study. If you need to contact us, please call 800-344-1386.
Sincerely yours,

{FS NAME}
Field Supervisor

As parent/guardian of the above named child, I consent to the appointment indicated.

___________________________________________________
Parent/Guardian Name

___________________________________________________
Parent/Guardian Signature

{LETTER CONTROL ID}

11e-16